What were your insurance company requirements for approval?

[BING9910 0]

Unfortunately, that's the way it went down for me, as well. I have UHC also. I had to pay my evaluations out of pocket, because they weren't covered period.

I agree with the part about paying out almost $500 and then UHC not covering surgery! That was my big fear! I was told the same things as you each time I called to verify what the stipulations were to be covered.

I was even told by one Care Coordinator that she couldn't tell me what specific comorbidities they cover because if she did, then all doctors would be putting them on all of their patients LapBand requests. She said it was based on a patient by patient evaluation.

After submitting my surgery request, I was denied, due to not having the comorbidities they cover, which were: high blood pressure, high cholesterol, diabetes, heart disease, and sleep apnea. However, I have all the other comorbidities! Needless to say, I was fit to be tied!

What am I paying my insurance premiums for, if I can't even find out specifics, to ensure I will be eligible, before shelling out nearly $500, only to find out I don't qualify!! Unfortunately for me, I don't have a money tree in my backyard!

Sorry, had to vent a little!

Melissa

[GramaLisa 0]

Hi Everyone! I got a letter today from a Clinical Support Coodinator. She is the CSC for our BCBS Fed. Employee Program. They say they cannot make a decision until they have received more info. Judging by the date of the letter, May 28, 2008, the doctor's office tried to get approval before I did any evaluations. I just finished up my psyche and nut. evals last week on Thursday. BCBS want the two evals, a copy of a sleep study, the Dr's price, and the name of the facility where the procedure will take place. This is the first I have heard about a sleep study. I don't think I even know what a sleep study is! LOL!!! Anyway, BCBS states that upon receipt of all the information requested they will make their decision within 5 working days and provide me with written notification. If they hear nothing by July 10 they will make a decision based on what little info they have. I am guessing they will say "no" with only a little info. Lisa:rolleyes2: