I have UH, timeline question!

redbone0528 · October 27, 2007

Hi all, I just found this board while conducting an exhaustive search online. There is so much information here, and I want to thank you for it. I have a question, and I am hoping that you all can help me.

Has anyone been able to travel from approval to surgery in less than 2 months? My doc is in the process of completing the letter to request the surgery. Considering that I have Type II Diabetes, PCOS, depression, and sleep Apnea, my insurance company insists that I have a 99% chance of being approved. My issue is, that I am over my out of pocket maximum for the year (surprise, considering that I have a thousand things wrong with me), and if I can get the procedure performed before the end of the year, I won't have to pay a cent. But if I wait, I will have to pay a ton of money. Has anyone had any success in getting the procedure in two months or less? Any doc recommendations? I already have my primary docs approval, and a therapist documentation. Any help or advice would be appreciated. Thanks!!!!! :help:

Chrisann · October 27, 2007

Make sure your medical plan runs on a calendar year. I just found out that mine runs on a plan year, which is July 1 through June 30.

Also, if your primary care physician can show you have had many attempts at weight loss, and he/she has documented it over time, that should help.

I had my psychological and dietician visit in Sept., my surgical consult early October, and they wanted me to schedule the surgery in November. My work schedule is preventing that, so I scheduled for January. Any money I spent so far out of pocket is carrying over too.

stacy73 · October 27, 2007

It is possible- Do you mean United Healthcare??- I have UHC and I did all my pre-op stuff before I got approved (they paid for everything!) so once approved you have final pre-op appt then surgery so yes it is possible-once I got approval I had surgery within one month-just depends on the dr and availability of sched appts.

redbone0528 · October 28, 2007

It is possible- Do you mean United Healthcare??- I have UHC and I did all my pre-op stuff before I got approved (they paid for everything!) so once approved you have final pre-op appt then surgery so yes it is possible-once I got approval I had surgery within one month-just depends on the dr and availability of sched appts.

Question, what preop stuff would be good to take care of now? I have had my sleep study, I am seeing a therapist who is on board, and I have an upper g/i scheduled, just in case. Is there anything else that you would suggest taking care of now? Any ideas you have will help, because I will schedule them all tomorrow! lol

stacy73 · October 28, 2007

I had my lab work done, ekg, chest x ray, upper gi, and psych consult in april-then when I finally was approved in august-I had to see interneal specialist to clear me for surgery and they just did a preop lab day of surgery-so anything you can get done before will help-plus if they find anything that may need to be looked at by a specialist it is better to know a month before than right before you want to have surgery- i have some Vitamin defieciencies that i never knew about-so i had to see a specialist before my surgery-so i was glad I started everything before-the insurance really can't deny any of these tests-so they should be covered. Good luck!!

redbone0528 · October 29, 2007

Okay, thanks for the heads up, I have my upper GI scheduled already, and I am gonna call my PCP tomorrow to schedule the EKG and the blood work. Is there anything else that I can do early? Can I see a nutritionist early, or will they make me do that anyway when I select a surgeon? Sorry for all the questions, but I am racing against the clock here. Thanks for all of the input ladies!:help: