karaserene1985

Wow, I'm sorry your waiting for your approval. My information was sent to UHC yesterday via fax and the case manager with Bariatric Resource Services called me within 3 hours of it being sent saying I was approved. I know what greatly helped speed up my process was that i called and got an 800 number for my surgeons office to "open a case" for me and then I got a fax number for them to submit it to. I also had been working with the case manager for 6 months making sure I was meeting all the requirements so she would have everything that was needed. Good luck and I hope your hear soon!

I also have UHC and it sounds like we have a similar policy. Mine will also be covered 100% minus my $250 copay for the hospital stay. I have had my insurnace since June 2010 so it has been less then a year and i have met with doctors for years to discuss my obesity so for me it is a pre-existing condition. My information was sent to insurance yesterday and i was approved yesterday. I would do the same as Deb suggested which is to call the case manager who is working on your file and ask lots of questions. Over the course of my 6 months of supervised diet, I probably called her 10 times and she was always, always, very happy to answer and help with my questions. Good luck! Kara

Hello All, I just need to vent and I thought here would be the perfect place. I was going to have the sleeve done April 15th of 2010 as a self pay. I cancelled my surgery date as I was not comfortable at the time with how fast the process went and I did not have the support of some very important family members. ~~~~ Fast forward to June 2010~~~~ I got a new job with excellent insurance that covers the sleeve at 100%. All I have to pay is my $250 deductible for the hospital stay. I started my insurance requirements which were 6 months worth of a supervised diet and a psych evaluation. The other item was that I need to have the surgery with a Center of Excellence. I located a center only 45 minutes from my home, (15 minutes from work) and that this would be great so close to home and I will have time to better prepare myself for this. ~~~~Fast forward 6 months later~~~~ I met with my nutritionist for 6 months and also did my psych eval. The nutritionist suggested meeting for one more month as I did not lose any weight during the 6 month supervised diet. So I met with her for the 7th month in a row on February 8th. At that time I had all my requirements for the center of excellence to submit to insurance. The center also had their own requirements which was I had to meet with their psychologist and their nutritionist. ( I did my entire 7 months with her and did my psych eval with thier person as well) I also had to have a letter of reccommendation from my PCP. I got a letter from my doctor who I saw for 15 years prior to moving to this area, as well as my new PCP who just did my annual exam and blood work. I also got past doctors notes from previous weight loss attempts as well as copies from my gym memberships showing attempts at weight loss. All of this was sent to the center of excellence prior to my February 7th NUT appointment so they would have everything in place to send to insurance. I also have been going to support groups, and a life skills group that was "suggested" by the center to go to. I have done everything I possibly can to make this easier. I have been in contact with the Bariatric Coordnator since my Feb 7th appointment to find out about my submission to insurance. She stated to me that they had everything they needed and it would be reviewed by the nurse practioner and then go to transcriptioning, after that it would be sent to the surgeon for a signature and then sent to the insurance company. She stated I would get a letter in the mail when it was sent out, but if I was able to get a fax number to send the information to, it would speed up the process. The very day I got the email from her, I called UHC and got a phone number for them to call to open up a case, and the fax number for them to send my information to. ~~~~Fast Forward to Feb 16th~~~~ I still hadn't heard anything about my submission to insurance so I contacted the coordinator and she told me that they are reviewed in the order they are received and mine was next to be reviewed by the nurse practioner. That is understandable I know they have to go in order. So I asked if mine was what a rough estimate of time would be for it to be reviewed. She could not give me an answer as the time varies for it to go through each step.... Yes... that is also understandable.... ~~~~Fast forward to today March 1st, almost 2 weeks from my last contact.~~~~ I emailed the coordnator to once again find out what was going on with my submission as I still have not received the letter that it was sent to insurance. I got a very rude email back saying that they went through a computer conversion last Friday and that the conversion took their time away from processing the submissions and that there is only one N.P. who works for the surgery department who also sees patients etc and that was the hold up on my submission. It has been over 21 days since they have had all my information to send to insurance and she stated on the 22nd the N.P reviewed it and it has been sitting in transcriptioning since. Now I know it seems like I am a Bi*** regarding the submssion, but really.... Does it need to take almost an entire month just to "review" it before even being submitted to insurance. The N.P. told me today she would ask transcriptiong to type up my letter... I just really hope they don't half A** is now and leave things out causing more delay! Sorry, I just really needed to vent about this. ****Crossing my fingers that by the end of the week my information will at least be sent to Insurance so I can find out if I'm approved or not**** Kara

Yes it is very strange the way my feelings changed. I was anxious and frustrated for approval.... Now I'm scared and anxious to get a surgery date and start this new chapter in my life. Very strange how fast the emotions came! Best of luck to all of you who are still waiting.... and sometimes being persistent is a good thing!

My center of excellence had my information for over 21 days and had many "glitches" in the way of it being submitted to insurance. Others were in line in front of me, I had to do an additional month with the NUT because I only lost 4.5 pounds during the 6 months of visits, they went through a computer conversion etc, etc, etc.... I was in contact the with bariatric coordnator weekly because I had not heard anything about it being submitted to insurance. I spoke with the coordnator via email this morning and she stated she would ask transcriptioning to type up my letter today to be sent. Well, only 3 hours after I received that email I got a phone call from my case manager at UHC that I was approved. Now all I need is to set a date! This has been a long frustrating process and I will be so excited to get my date! Now, as long as it does not take my center of excellence an additional 21 days just to give me a date! lol... Woo Hoo.... Finally see a light at the end of the tunnel! Kara

OMG! WOULD YOU BELIEVE THAT AT 4:31 THIS AFTERNOON THE CASE MANAGER FROM UHC CALLED ME TO SAY I HAD BEEN APPROVED?!? THIS NEVER WOULD HAVE HAPPEND IF I DIDN'T STAY ON TOP OF MY SUBMISSION. I KNEW AS SOON AS IT WAS SENT I WOULD RECEIVE A FAST DECISION BUT I DIDN'T EXPECT WITH IN 3 HOURS! SIMPLY AMAZING... NOW JUST NEED TO SET A DATE!

No crying here.... Just lots of frustration.... I think that is why this it is so hard.... I have been doing this supervised diet for almost 8 months now. Work out on average 3 times a week for an hour and a half and I have only lost 4.5 pounds. If you don't count what I gained while my body was getting used to eating all the higher fat more Protein items.... It is very hard to stay motivated and I just want to have the surgery to have the "tool" to help my efforts at losing weight. Its no wonder after 7 months I have only lost 4.5 pounds. The story of my life... Thats why I need the surgery to help. The biggest step to getting the surgery for me at this point is getting approved by insurance and I am having a very hard time waiting...

I also have UHC. Do you know if your information was mailed, or faxed? My information should be on its way to them so I am just curious on my turn around time. I was told my be case manager at UHC (Bariatric Resource Services) that she can approve within 24-48 hours if she has everything and it is faxed. Congrats on your approval!

I have UHC but work for Guardian Life Insurance Company. Each policy is different and has there own requirements.

I feel just like you! I had my last nutritionist appointment on February 8th., I had everything I needed to submit to Insurance at this appointment. I hadn't heard anything from my center of excellence a week later so I emailed the bariatric coordnator. I asked her what my status was as they had everything they needed to be reviewed for a week already. She told me that the nurse practioner looks at the files in order they are received on the desk and at that time mine was next to be reviewed. She said the nurse practioner would review it and then it would go to transciptioning and then needs the surgeons signature and then could be faxed to insurance. (I also have UHC). She stated that once it is sent to insurance I would receive a letter in the mail. It has been another week and still nothing. I took the extra step to call my case manager at UHC to get the 800 number and fax number needed to open a case for me and fax directly to my case manager. Speaking with my case manager she stated that once she has everything she can make an approval within 24 to 48 hours. My problem right now is that is has been 2 weeks that my center of excellence has had all my paperwork ready to send to insurance and they still have not sent it. I know it has to be in the order received on the nurse practioners desk, but really how long does it take to review my file, send it to transcriptioning, get a signature and fax it..... I am getting so annoyed... I'm going to wait until Monday and if I have not received my letter that it was sent to insurance I'm going to be very angry. All this waiting has really made me lose my motivation. I'm finding it harder to stay on my diet and work out.... I almost feel like whats the point.... If I at least had my letter that it was sent I would feel stronger and see a light at the end of the tunnel.... I find this no fault of UHC. They have been great throughout this whole process answering every question I had, and returning my calls. It is just my center of excellence that has had there own rules and requirements that I had to wait longer and who is holding up the process.... Anxiously waiting! Kara

Very familiar with Manty, I actually grew up just outside of Cleveland and went to Kiel schools. Its a small world sometimes. Good luck today! I'm sure they won't have any issues doing in laproscopicly. Just curious did you ask Dr. Kemmerling how many sleeves he had done? At this time last year he had only done about 10 of them and had one leak. He did explain the person with the leak had a wide range of issues causing him to be a very high risk surgery. Just curious how much experience he has since last year. I know he has been around for several years and has done tons of the other surgeries. I do have to say, I would like to thank Dr. Kemmerling because I first heard of the sleeve at one of his seminars. I was interested in the band before I heard of the sleeve that day. I see his commercials on tv all the time for his seminars and I think where would I be now if I had never gone to his semianr last January! Hey.... remember to walk, walk, walk today! That's what they all say! Let us know how it goes! HAPPY VALENTINES DAY!

Wow.... good luck tomorrow! I am also from Green Bay. I actually was going to get sleeved last year by Dr. Kemmerling on April 15th but was a self pay and my mother was not very supportive. I have obtained insurance since then so now am currently going through the insurance hoops. My insurance requires the surgery to be done by a center of excellence and Dr. Kemmerling is not. I will be having my surgery with MIdwest Bariatric Solutions out of Neenah. I am quite happy with going through Midwest Bariatric Solutions rather then Dr. Kemmerling. When I met with him everything went so fast. I had a 5 minute appointment and then he said your good and we scheduled surgery. There were no preop requirements. It was very fast. I don't think I was mentally prepared. With my insurance requirements, I had to do a 6 month supervised diet, and a psych eval. I think I am so much better off w/ MBS then Dr. Kemmerling. I feel so much more prepared. In case you are wondering, I am 25 years old, 5'8 and currently 316 pounds. I wish you luck on your surgery tomorrow. It is a great V-day gift to yourself. I'd love to keep in touch since we are from the same area. I have not met anyone else from GB or the surrounding areas on here. I am hoping to have my surgery by mid March. I have all the requirements together and MBS should be submitting to insurance either the end of last week or the beginning of this week. I'm so excited to finally get this going. It seems so long since I started this process. Once again good luck with Dr. Kemmerling. I've known a few people who have had the surgery with him.

A pre-op diet is required to shrink the liver. All surgeons have different pre-op diet requirements. Mine is the same diet I have been doing for 7 months. High Protein, low carb. I don't have to do a liquid only, or one meal only ect. I get 3 balanced meals each day w/ low carbs.

I have UHC and am going for my 7th month check up with my nutritionist today. As long as I show a drop they will be submitting my info to insurance for approval. I had to do a 6 month supervised diet (now in my 7th month) and a psch eval for UHC. For my surgeons center (center of excellence) I had to see there nutritionist for at least two months, and there psychologist. have 6 months worth of supervised diet, personal letter from my primary care doctor indicating the necessity for the surgery. I did everything through there center to make sure I am meeting all requirements for both. I called twice to verify if the sleeve is covered and it will be..... AT 100%! I have great insurance and my only out of pocket cost will be my copay of $250 for the hospital stay. Everything else is 100% covered. I am hoping after my appointment today my nurse coordinator will submit to UHC and I will have a quick turnaround on a decision. I do not have any comorbities but I am 25 years old, 313 lbs, and have a BMI of 47.5. I have also included notes from my doctor from the last 4 years showing my weigh in, and meeting with her to discuss my obesity. I meet all UHC requirements so I don't see how they could deny me but I am worried! Hopefully she submits it by the end of the week to insurance and I can finally be on my way.... Once you had everything in to UHC how soon did you hear a decision? I am hoping to have the sugery mid to late March.... I've heard some of you say within 24 hours. That would be FANTASTIC, because then I could finally have a surgery date!

Hello, Tomorrow is my 6th month appointment with my nutritionist for my supervised diet. This is an insurance requirement for my UHC insurance. I have been meeting with my nutritionist once per month since July. My supervised diet consists of no carbs. Each meal should consist of 3 ounces of Protein one cup of fruit and one cup of vegetables. I have been following the diet to the letter and I have not lost during these 6 months. Each month I go in and she tells me something different to do. I thought finally I was down but then nothing changed in my diet/lifestyle and I gained it all back. I'm so frustrated. Obviously diets don't work for me and that's why I am wanting to do the surgery. I'm 5'8 and 317lbs. My highest was 323 and that was 3 months ago. Like I stated my weight has been up and down during these last 6 months and I just don't know what to do. I don't think its an insurance requirement to lose weight during the 6 months, but just to have a supervised diet. My nutritionist told me at my last appointment that she would like to see me down 10-15 pounds during the 6 months. I have a feeling tomorrow she will tell me that she wants to monitor me for one additional month. I don't see what the difference will be. I know your questions will be, well how about excercise. Right now its non exisitent. We are on mandatory overtime at work and I'm putting in over 65 hours a week. I sit all day! I take the stairs and walk as much as I can. I can't help that I don't have time to work out. I'm also a full time student so I have no free time! I have eliminated all caffine per the nutritionist and with all this overtime I am dying! I can't tell you how much I would like a cup of coffee! Have any one you had trouble with the low carb diet? Like I said, I was finally down last week but I think I found the answer to why i gained it back. I lost 7 pounds during the week of my period. I was not taking my birth control pill. As of Sunday when I started taking my pill again, I gained 4 pounds back. ...... And I'm not getting off my birth control.... This supervised diet is also my pre-op diet. My surgeons don't put the patients on a liquid only diet. The low carb diet is to shrink the liver. I can't tell you how small my liver must be right now after doing 6 months of this but it's crazy that I haven't lost any weight! Has anybody else out there had trouble losing on the low carb diet?!?!?!? Will see what my nutritionist says tomorrow. I hope she still sends my info to insurance for approval without making me wait one more month. I'm so worried about other health factors now such as high cholesterol ect. I never used to eat this much meat and fat. ---------Kara