yzplnxg
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Everything posted by yzplnxg
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Call your insurance company and ask if WLS is covered then ask them for the exact wording of the requirements. I have choice plus as well. If it's like mine, I can help you by telling you what I did...
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I am Manager as well and got approved. If you have problems or want to discuss send me a private message.
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Well, I'm very weak from the swine flu. It's the second week. The sickness part is gone but I have NO ENERGY!! I had a little more energy today. I didn't have to stop but twice on the way in from the parking lot to the office this morning. I do not want to have surgery until I get my energy back. I called the doctors office and asked them if they had been notified by UHC that I was approved. The ins. cleck said she had been very busy and didn't know. She said why don't you fax what you have. I did that today. I didn't hear anything from them. Clearly, they must have a LOT of patients because I'm not a priority. I wonder if I ever called them again if they would care. Oh well... I need to concentrate on getting better and I would like to find a support group in my town. I have been so consumed with working on the ins. appeal that I'm afraid I've forgot everything I knew about how to eat after surgery. I want to research that and find a protein shake I can drink and get some things in the house that will be OK to eat. With the Swine Flu, I lost over 11 pounds in a week. It was a really bad way to loose but they're gone just the same. I'm working hard to eat right and keep this weight off. I'm tired so I'm closing. Hope you are doing well!! :thumbup:
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Well, I'm very weak from the swine flu. It's the second week. The sickness part is gone but I have NO ENERGY!! I had a little more energy today. I didn't have to stop but twice on the way in from the parking lot to the office this morning. I do not want to have surgery until I get my energy back. I called the doctors office and asked them if they had been notified by UHC that I was approved. The ins. cleck said she had been very busy and didn't know. She said why don't you fax what you have. I did that today. I didn't hear anything from them. Clearly, they must have a LOT of patients because I'm not a priority. I wonder if I ever called them again if they would care. Oh well... I need to concentrate on getting better and I would like to find a support group in my town. I have been so consumed with working on the ins. appeal that I'm afraid I've forgot everything I knew about how to eat after surgery. I want to research that and find a protein shake I can drink and get some things in the house that will be OK to eat. With the Swine Flu, I lost over 11 pounds in a week. It was a really bad way to loose but they're gone just the same. I'm working hard to eat right and keep this weight off. I'm tired so I'm closing. Hope you are doing well!! :tt1:
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I'm approved... finally. I've had the swine flue so it's been rough this week.. I finally have something to smile about!! :huh2::tt1:
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I'm approved... finally. I've had the swine flue so it's been rough this week.. I finally have something to smile about!! :tt1:
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I just opened my mail to find my APPROVAL letter!!!!!!!!!
Yea!!! I didn't think this was ever going to happen. Two appeals later, I finally got it right!!
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Letter From Insurance ???
yzplnxg replied to BooCakes's topic in PRE-Operation Weight Loss Surgery Q&A
They have had the appeal for ten days. I should hear something back on the 17th. I'm holding my breath!! The denial said they needed "a diagnosis of morbid obesity of over five years" I sent in a letter from my PCP I was a page type written from my PCP outlining all the things he was treating me for and the times I had been treated for weight control.. and a sentence saying I had been morbid obese for over five years.. I'm hoping that will surfice. I have no way of knowing what they are reallying looking for... Oh well... I am so hoping the wait is almost over!! -
OK.. I work for AT&T as well. Please post if either of you get approved. I've working through an appeal now.
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Letter From Insurance ???
yzplnxg replied to BooCakes's topic in PRE-Operation Weight Loss Surgery Q&A
I sure did. My PCP was supposed to have sent a letter outlining my co-morbiities. He had sent one letter saying I had to have thyroid surgery. I thought they had gotten the second letter.. which would have provided the "five year diagnosis of morbid obesity" which UHC requires.. I told the ins clerk the requirements.. It wasn't until the appeal that I asked the surgeon's office to make a copy of everything they sent the insurance company that I realized what was missing. I'm still in the appeal and hope I have given the insurance everything but I may still get something saying they need something else.. I should know something by the 17th. I wish UHC would tell me what else they need BEFORE they deny me so I would have the opportunity to provide the info BEFORE the denial. -
Three phone calls and more frustration!!!
yzplnxg commented on hope2bthinr's blog entry in Blog 62387
I beleive they were dragging their feet to make sure you had to pay the deductable.. -
Does anyone have UHC through AT&T? Anyone get around the five year requirement for BMI greater than 40 with co-morbidities or with a summary letter from doctor stated you have been morbidly obese for the last five years and have been treated for weight loss?
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My surgeon's ins assistant sent in everything to the insurance company... I thought. Come to find out there was a physician's letter that was not sent in that was needed. I was denied. When I go the denial I called her and she sent in for an appeal. Come to find out she wrote the letter herself and did not send in a physician's letter with the appeal so it was denied for the second time.. Now I've waisted two appeals. I know this because I went and picked up everything she had submitted to the insurance company. My question is this.. I am considering changing surgeons. I'm not happy with service. If I start the process all over somewhere else with another surgeon, how will this affect my insurance and the appeal. Does anyone know?
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I was denied today.. BAD NEWS!!!! My UHC does cover the surgery with BMI OVER 40 with five year weight history. I had 4 BMI over 40 and one year at 35.5 (when I took diet pills.) I do have high blood pressure and Acid reflux but I was still denied. The doctor is going to write a letter stating this is medically needed and Lori is going to fax it to them tomorrow. I am wondering if this will be enough...
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Thank you for the kind words. My surgeon sent in an appeal. I am waiting to hear what they say. I have sent off for the wording on my plan (just in case.) I'm going the Obesity Law if this doesn't work. With high blood pressure, type II diabeties, GERD, incontinence I know I would benefit from having this surgery. I hope UHC does the right thing..
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United health care 5 year weight history.
yzplnxg replied to jem8384's topic in Insurance & Financing
Becky Lou, How is the fight going? Are you getting anywhere? -
They did not say it had to be five years in a row. It dawned on me last night that I could probably go back to prior years.. I would love to see the letter you used. My email is necholeheadley@gmail.com Anything you can send is greatly appreciated...
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United Healthcare Will Kill Me Before My Weight Ever Will.
yzplnxg replied to m&nsmama's topic in Insurance & Financing
I am working on an appeal with UHC. Does anyone have a sample of a letter from the PCP diagnosising morbid over a minimum of five years? I need to send something to my doctor showing him sort of what I need it to say.. -
I didn't have all the BMIs over last five years.. I was denied. I'm working on appeal. Any info from people that work from AT&T would be greatly appreciated.
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I work for AT&T and was turned down. I do have documented co mobities. I had four years BMI over 40 and one year 35.7.. They said flat you have to have all years over 40... I am appealing. Any info any one has would be greatly appreciated. KingsFan I would be interested in knowing if you are approved.. and if you had the five years BMI
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I work with AT&T on east coast. I was told my UHC i hae to have five year weight history from physician bmi over 40 period. I did not have all five years.. They denied me. Nothing in Appeal said they would approve surgery if I have comorbidities. I documentment them. I had four BMI's over fourty and one at 35.7 when I was taking diet pills. I'm trying to appeal. If ANYONE has a simular situation and was successful I would love to hear from you..
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UHC Requirements - What do you think??
yzplnxg replied to Thin4Anisha's topic in Insurance & Financing
RickyRoss831, I have UHC insurance and had only one year under 40bmi and I got denied. Did you ever get your approval and if you did.. how? Nechole -
Please keep me informed as to your progress...
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United health care 5 year weight history.
yzplnxg replied to jem8384's topic in Insurance & Financing
You can appeal I have read a lot about appealing. I sent you my email. I would like to talk with you. Also. What is HTN. ???