UHC and possible denial???

nilesmama08 · March 17, 2011

I had met all of my insurance requirements. According to my plan I must complete 6 months of diet visits and 6 months of support groups. I attended several different support groups in my area.

My NCM told me that my groups were "unapproved" support groups therefore, she will not approve my case and will have to attend 6 additional months of "approved" support groups. I attended groups led by post op wls patients. UHC wants me to attend groups led by nurses, docs, or psychs.

I am pissed at this point because I know coworkers that were approved with the same support groups but they had Cigna(same employer insurance). I can't believe a support group would stop me from having surgery.

I guess I will have to appeal the decision of my NCM. Any thoughts?

KinkySlinky · March 17, 2011

I would appeal... What's the worst they will tell you? "Sorry, it's still denied.".... But to be real honest... the appeal probably won't go over very well.. Just prepare yourself for another denial... Sorry!!!! I can imagine that is unbelievably frustrating and almost devastating...

I know this probably isn't what you WANT to hear but it's the truth

Good luck!!!