Gettin Insurance to Approve

[baribabe72 33]

Hi, I have UMR (part of United Healthcare) and I live in NC. I have a bmi of 35 with multiple comorbidities. UMR requires a 6 month waiting period, tons of tests, and lots of hoops to qualify for sleeve surgery. Im doing everything they ask. I guess they can still turn around and deny the surgery. What can I do to keep that from happening? All this testing is going to be a good $10 grand if insurance does not pay. Plus I dont want to get everything set up just to get denied.

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[KristenLe 5,979]

@@baribabe72 My surgeon had me go through the psych eval, nutrition and 6 months of supervised diet to get the authorization - once that was approved - that's when they ordered the required testing. Be sure to get written guidelines from UMR as to what the requirements are and speak to the insurance coordinator at your surgeon's office to ensure you are meeting all of them and documenting that properly.