AKessler731 2 Posted February 16, 2016 Well that was new...I called UHC to check on the status of my paperwork and I was transfered to the bariatric resources department. I had to enroll in their program and set up an appointment for their nurse to call me next Monday at 1:00 to go over my paperwork. The surgery is approved on a case by case basis. Anyone else go through this? Share this post Link to post Share on other sites
haleymarie 35 Posted February 16, 2016 It's different for everyone...I have Uhc and they told me there was no bariatric nurses with them... Share this post Link to post Share on other sites
jonfsgirl 1 Posted February 16, 2016 OMG...I just got a call from my doc and UHC has denied me because my BMI isn't 40 and my BP is controlled with medicine. Now I have to submit my sleep study report and my doc is going to try to get it approved with that info. I am sooooooo upset. I want to cry and give up. This is the hardest thing I have ever tried to do. Share this post Link to post Share on other sites
AKessler731 2 Posted February 16, 2016 OMG...I just got a call from my doc and UHC has denied me because my BMI isn't 40 and my BP is controlled with medicine. Now I have to submit my sleep study report and my doc is going to try to get it approved with that info. I am sooooooo upset. I want to cry and give up. This is the hardest thing I have ever tried to do. What is your BMI? I'm just curious...what if you gained a little weight? Would you BMI be over 40 then? Share this post Link to post Share on other sites
Thinny 30 Posted February 17, 2016 I spoke to that muse today. She went through her checklist but I was like did, done, next etc. The only good thing I got from. Her was a form for my pop to document my 6 months. Also something to show 5 years with BMW over 40. Those forms are good because she kept asking me to send her a sample. Now I have it in uhc approved format. She said she'll check in the day after surgery then 30 days after. That's all! Share this post Link to post Share on other sites
Susan Michelle Autry 10 Posted February 17, 2016 OMG...I just got a call from my doc and UHC has denied me because my BMI isn't 40 and my BP is controlled with medicine. Now I have to submit my sleep study report and my doc is going to try to get it approved with that info. I am sooooooo upset. I want to cry and give up. This is the hardest thing I have ever tried to do.What is your BMI? I'm just curious...what if you gained a little weight? Would you BMI be over 40 then? My BMI is 37.1 I would have to gain 16 lbs to be a 40 and I don't want to do that at all Share this post Link to post Share on other sites
JennWeb 28 Posted February 17, 2016 I have UHC and was approved today, a week after it being submitted. Never had to talk to anyone from my insurance. When it was submitted my BMI was listed at 38 but has dropped to 35. I have sleep apnea. Share this post Link to post Share on other sites
Susan Michelle Autry 10 Posted February 17, 2016 That's great news for you. Congrats! Hopefully I will hear good news next week once my surgeon resubmits with my sleep study report. I really don't want to go to Mexico unless I have no other option. Share this post Link to post Share on other sites
karen091866 120 Posted February 17, 2016 We're covered by United Health Care through my spouse's employer- and registering with a Bariatric Resource Coordinator was required. I think it must have to do with the specifics of your group. I'm 3 months post-op & the Bariatric Resource nurse was a great help- she made sure that all of the requirements were done in a timely manner, she helped facilitate appointments in a timely manner, was the primary contact while I was being approved - and even made a few post-op phone calls to make sure I was doing well. The extra oversight made for a smooth process. Share this post Link to post Share on other sites
AKessler731 2 Posted February 17, 2016 Well thats good to hear. The lady who I talked to was kind of like "you'll have to talk to this lady to get approval" like it was something bad. She made me really nervous that I wouldn't get approved. She said they only approve revisions on a case by case basis and you have to show that its medically necessary. I meet all of the criteria so I hope it's fine. When I looked up the criteria it said to be medically necessary you have to have a BMI of over 40 or over 35 with co-morbitiies. My BMI is like a 40.1. lol But its over so that should be good enough. I'll just be happy when it's approved. I hate being in the waiting period. Share this post Link to post Share on other sites
CBT 450 Posted February 17, 2016 (edited) We're covered by United Health Care through my spouse's employer- and registering with a Bariatric Resource Coordinator was required. I think it must have to do with the specifics of your group. I'm 3 months post-op & the Bariatric Resource nurse was a great help- she made sure that all of the requirements were done in a timely manner, she helped facilitate appointments in a timely manner, was the primary contact while I was being approved - and even made a few post-op phone calls to make sure I was doing well. The extra oversight made for a smooth process. Exactly the same for me in 2012! I had approval 24 hours after my doc submitted the file! I remember how nerve wracking and edgy I felt. I really don't trust people. Haha! Edited February 17, 2016 by CBT Share this post Link to post Share on other sites
Susan Michelle Autry 10 Posted February 17, 2016 I have UHC and was approved today, a week after it being submitted. Never had to talk to anyone from my insurance. When it was submitted my BMI was listed at 38 but has dropped to 35. I have sleep apnea. Share this post Link to post Share on other sites
Susan Michelle Autry 10 Posted February 17, 2016 JennWeb.. MY BMI is 37.1 I have high BP and sleep apnea. United health care denied me due to my BP being controlled with meds. I'm waiting to hear in a second submission with my sleep study report Share this post Link to post Share on other sites
JennWeb 28 Posted February 18, 2016 JennWeb.. MY BMI is 37.1 I have high BP and sleep apnea. United health care denied me due to my BP being controlled with meds. I'm waiting to hear in a second submission with my sleep study report I'll be praying that they approve you. Don't know why they wouldn't have. Share this post Link to post Share on other sites