puffyone

Hey, best of luck...try not to worry, much easier said than done. I was a mess while waiting for approval. My BMI was 37 as well and I was approved in less than a week. Keep us posted! puffyone

All of a sudden my date of "11/10" has become....."this Thursday"!! Dr. Pinnar/Reston Virginia

Has anyone had an abnormal barium swallow? I am scheduled for my band on Nov 10th. All my tests came back good. Then I got a call from my surgeons office saying that on further review it appeared that my barium swallow indicated that I had tertiary contractions in my esophagus. Now I need to see a neurogastric doctor. I am freaking out because was finally at that calm excited stage ready for my surgery. I am incredibly thankful that my surgeon is so thorough, but I will be so upset if this prevents me from getting my band. I don't have GERD or any other weird symptoms. Anyone familiar with any of this??? Thanks for any help/advice you can offer! Puffyone

I just made my first inquiry call to my insurance company (UHC-PPO) to request a status update on my case (approved?, denied? need more inf???). Anyway, the person that I spoke with told me that a letter had been sent out on 10/6 with the information that I was requesting. I asked her why she couldn't just tell me if I had been approved or denied, and she said she couldn't, I would have to wait for the letter. Does this seem normal to anyone. It seems like I have read a number of posts where people have been able to get their status over the phone. Should I take this as a bad sign?? Also, as an fyi, I do know that there is NO exclusion in my policy and that UHC confirmed that they cover Lap Band. Thanks for any help.... Anne

Can anyone help refresh my overloaded brain as to where I might find template letters for PCPs? I have everything in order including pre-op testing, op-date, insurance approval etc. etc., but I need a letter from my PCP stating medical clearance/necessity. When I spoke to her she asked me to provide her with a template letter that she could fax to my surgeon today. I want to make sure that the wording is correct so I don't have to do this over again. Thanks for any direction or advice! puffyone:glasses

Miranda, My advice is that you get at least three different care coordinators "take" on what UHC does and doesn't cover per your policy. When I was having trouble getting a straight answer out of them I followed the advice to keep calling and asking the same question. Low and Behold when I got another rep on the phone I received the correct information. UHC DOES cover the band unless there is a specific exclusion in your policy. UHC DOES cover bariatric surgery when deemed "medically necessary for morbid obesity" unless there is a specific exclusion. The verbiage in these policy documents can be really confusing so your best bet is to call and try to speak with a manager. Even though I was able to get confirmation over the phone that I had been approved, it took twice as long as they said for me to get it in writing and then when I did get the letter it was written in such a way that suggested that the surgery might not be covered. Anyway, once again I called and talked to the care coordination department, asked for a manager and had it all deciphered. If you have a hard copy of your ins. policy in hand and look for the section titled "exclusions" you should find something referencing weight loss surgery or bariatric surgery. Usually the exclusion language includes some qualification with respect to morbid obesity and medically necessary. Good luck. Keep me posted. I'll be thinking about you and hoping for success. This time last month, prior to my approval, I doubted that I would ever be in the position to say that I was approved. Anne (puffyone)

If I could, I would be dancing in the streets of my neighborhood! (it's pouring rain with thunder and lightning) screaming "yea for me yea for me"!! I just learned that my insurance co. UHC, approved me after less than a week of having my paperwork. My surgeon's office did everything! I have a date of November 10th...exactly one month after my 42 birthday. What more could I ever ask for??? I am so excited, thrilled, scared and blessed....all at the same time. Here I am, on the road back to the me I use to be...just older and wiser! Anne

After following the sage advice of 5 members that responded to my past post regarding my insurance status I called UHC two more times. The people I spoke with were beyond helpful. One care coordinator told me that there was absolutely NO reason I should have to wait for a letter to arrive and that I should be able to learn whether or not I was approved over the phone. Unfortunately, there is some policy they have that a "manager" or "nurse" must inform the patient of the denial or approval. She advised me to call another number. When I did I talked to a wonderful manager who informed me that I had been approved! She wished me the best of luck and told me that she had heard great things about the success of Lap Band. I am so excited, scared, thrilled, giddy and apprehensive....all at once. My date is for November 10th!! Thanks for everyone's kind help and advice so far. Anne

Thanks you guys. I so appreciate your replies. I am having stomach pains just worried about all this. The waiting alone causes enough stress to make anyone qualify!!! I'll probably call back and see if I get someone else. I don't know how I will be able to survive until tomorrow (or maybe later!) waiting for the mail. Anne