Need encouragement

gunn4ya · October 11, 2004

Well I'm on week number 3 and we still haven't heard anything from the insurance company. I have United Healthcare. Does an insurance approval take this long? Does anyone else have United Healthcare? I'm losing hope.

New Hope · October 11, 2004

Tanya, there's no way to tell how long it will take. Some bandsters have been approved in 2 weeks. I had United, was denied, appealed, 8 months later approved. Don't give up hope!

Get busy walking, drinking that ton of Water (but not with meals), wearing all your favorite clothes (that will be too big in a little while), and eating healthier food choices. That will put you ahead of the game when you do get approved. Best of luck to you!

Iluvharleys · October 11, 2004

Good Luck Tanya! I hope you will be approved.

Maurice · October 14, 2004

I waited eight months for Blue Cross/Blue Shield-Minnesota to cover banding at all. Once they accepted it, the approval only took a few weeks.

The wait gave me time to be further committed to changing my life, but at the same time, gave me more time to be nervous about it.

Good luck, eh.

leatha_g · October 14, 2004

Tanya,

I have heard great things about this insurance, as far as band approval goes. Try not to get too discouraged. Have you called them? Sometimes, if you call them, they'll give you a contact number and a case# to check back on. This helps you to feel at least a bit more empowered. I would definitely call and just tell them you wanted to make sure it has been received. They'll usually tell you where it is at the moment.

Good luck!

Alexandra · October 14, 2004

Tanya, if you haven't already done so I definitely recommend calling them tomorrow, Friday. Make sure your case file is complete and they're not waiting on some tiny piece of information from your doctor's office or something. That's the most common reason for delays in approvals and so on.

Good luck!!

CandyB · October 15, 2004

Hi Tanya,

I just wanted to let you know that I have United Healthcare PPO, and they approved my surgery. (An aside: My doctor was out of network, but they paid well. I didn't owe him too much money afterwards. I did ask him, before surgery, how much money he needed to receive totally from the ins. co. and me combined. I'm glad I did that because, after the surgery, his office billed me for more that he had told me, and I questioned the amount based on what I had been told prior to the surgery. After letters back and forth, he decided to accept the original figure - whew!) Back to your question. My insurance approval was not without a specific glitch, however. But the glitch (and hence postponement of surgery) was for two reasons:

1.The surgeon's office was supposed to contact UHC one month in advance of the surgery date for approval. They only contacted them two weeks in advance, and when there was a question of eligibility by the ins. co., the answer couldn't be sorted out in such a short time.

2. The employer through which I have my medical insurance goofed on their end as far as their coverage of weight loss surgery. They told me that they covered it, but the ins, co. did not have it on their approved list of procedures. I had to get the patient advocate at work involved to straighten it out. Eventually, it was all OK'd, and everything was fine.

So, be aware that it is not always the insurance company trying to be difficult. In my case the surgeon's office dropped the ball in their timing (They knew better, and yet they tried to blame the ins. co.) And the employer had dropped the ball, too. They had not given an accurate listing of approved procedures to the ins. co.

Also, be aware that each employer has many options in the plan they purchase from UHC or any other health care provider. So your UHC and my UHC may not provide the same coverage at all.

I hope this information was helpful to you. You should call UHC to find out if there is a problem in approving your surgery. Don't wait for them. You won't feel as frustrated if you are actively involved in the process.

Best of luck, CandyB.

biggun · October 15, 2004

I have United Healthcare too. It took me 2 weeks and my doctors face lit up when I told him who I have. He told me they are the easiest company to deal with and have a high approval weight. Give it a little longer and they will call in no time with your approval. My surgeon didn't even charge me after the approval I jsut had to pay my 10% to the surgery center for their work. My total has come to $958.00 for the entire surgery. Hang in there!

Kim