M2G 1,836 Posted November 5, 2010 So I'm 2 weeks out from surgery today and I got the nicest call from my bariatric Nurse Case Manager. She was the one from UHC that 1. decided if I was 'eligible' and a good candidate for the surgery, and 2. the single person who decided YES or NO once my case was submitted from the surgeon's office. I had also a bariatric case manager who was much more accesible than the nurse, and my case manager was wonderful, answered any questions I had and sometimes would actually answer the phone, but always returned every call, etc. She called and left a very nice message on my cell phone the day of surgery wishing me good luck, etc. But the nurse I only spoke once to, and then played a couple of phone tag messages with her before surgery, so I was surprised that she called me today. I'm sure it is all part of her job to follow up with the patient, but she was great, asked me all sorts of questions about how I was feeling, and was very nice and supportive. I think sometimes insurance people and insurance in general is such a pain to deal with, it was nice to know that there are real people out there, and even though yes, they are doing their job, it was nice to know they actually cared. Share this post Link to post Share on other sites
MINI-Me 196 Posted November 5, 2010 What a great story. Thanks for sharing. Share this post Link to post Share on other sites
Sharrinslife 2 Posted November 5, 2010 So I'm 2 weeks out from surgery today and I got the nicest call from my bariatric Nurse Case Manager. She was the one from UHC that 1. decided if I was 'eligible' and a good candidate for the surgery, and 2. the single person who decided YES or NO once my case was submitted from the surgeon's office. I had also a bariatric case manager who was much more accesible than the nurse, and my case manager was wonderful, answered any questions I had and sometimes would actually answer the phone, but always returned every call, etc. She called and left a very nice message on my cell phone the day of surgery wishing me good luck, etc. But the nurse I only spoke once to, and then played a couple of phone tag messages with her before surgery, so I was surprised that she called me today. I'm sure it is all part of her job to follow up with the patient, but she was great, asked me all sorts of questions about how I was feeling, and was very nice and supportive. I think sometimes insurance people and insurance in general is such a pain to deal with, it was nice to know that there are real people out there, and even though yes, they are doing their job, it was nice to know they actually cared. Hi Mommy2Girls, Thank you for all your post they have been really great for me to read . Your attitude about your surgery has been really inspiring to me. I also have UHC and am wondering how long from the time you submitted did it take to get the approval . My surgery is scheduled for 11/29 but I lose that date on the 22nd if they have not approved by then. I am both really excited to have the surgery and terrified at the same time some times in the same minute.LOL Sharrin Share this post Link to post Share on other sites
M2G 1,836 Posted November 6, 2010 Hi Sharrin! I was told by my bariatric case manager, that UHC gives themselves 15 days from the day they receive your case to give an answer. I didn't ask, but I am assuming that is 15 business days. I thought that my nurse was going to be out of town the week after my case was submitted (it was submitted on Tues. Oct. 5th and by the 8th I called wanting to know how things are going and that is when I found out about the 15 day rule and that my nurse was going to be out of town.) I still don't know what happened but I recieved a phone call on Wed. Oct. 13th that my case was approved. Is your case already submitted? If so it sounds like you will have an answer by the 22. My surgeon wouldn't even schedule a date until I was approved (that drove me crazy but I totally understood.) Thanks for the kind words, I am so thankful every day for this site, it has given me tons of insight, inspiration and help too! Share this post Link to post Share on other sites
Sharrinslife 2 Posted November 7, 2010 Hi Mommy2girls, I think he gave me the date so that I could schedule the rest of my life because i am half self employed and half corporate employed. My Insurance is changing as of December 31. We know that we will have UHC what we do not know is what policy within the UHC. The Policy i have know pays for the sleeve some of the other policies do not. I am going to call on Monday and see what they say. Share this post Link to post Share on other sites
M2G 1,836 Posted November 8, 2010 Hi Mommy2girls, I think he gave me the date so that I could schedule the rest of my life because i am half self employed and half corporate employed. My Insurance is changing as of December 31. We know that we will have UHC what we do not know is what policy within the UHC. The Policy i have know pays for the sleeve some of the other policies do not. I am going to call on Monday and see what they say. You are right about policies changing from year to year and what is covered and what isn't. When I expressed gratitude towards the UHC nurse that they cover the sleeve, she extended some of that gratitude back to my husband's employer (that is where our insurance comes from) because they CHOOSE that policy that covers the sleeve. Good luck, I hope you get your answer soon! Share this post Link to post Share on other sites
educationrulz 18 Posted November 22, 2010 I have also received some followup calls from the UHC Nurse. They had told me they would do that and I thought it was going to be a pain, but it ended up being a nice conversation both times. They were giving me a lot of info that I already had because I had done so much research, but it's a great policy because some people don't do as much research and may need more post op support and followup. They asked a lot of questions about my post op habits and reminded me that I needed to get my labs done. That was something I hadn't thought much about. Our conversations also triggered me to stay on track with some things like water/fluid intake and excercise. I know they are doing their job but it's a nice touch and good business also. Share this post Link to post Share on other sites
Blsmbry 13 Posted January 21, 2011 I have UHC ins. in Florida. I know this may sound like a stupid question, But how do I go about by requesting and/or getting a case/ nurse manager to assit me in my approval process? Does it have to be a covered benefit or can I just request one? If so, how??? I would greatly appreciate your help. Thanx!! Share this post Link to post Share on other sites