How long for your decision from UHC?

[big_daddy 0]

Hey all, been lurking here for a while now and am now playing the waiting game with UHC.

My request was submitted on 9/11 and I'm just curious as to how long it has actually taken you guys to get a response. I know they have up to 45 days, but I was just curious as to what the reality of the timetable is.

Thanks!

BD

[sherry62 0]

(UHC) approved me in less than 2 weeks.

Good luck!

[salome000 0]

The first time, when I was denied, it took the entire 30 days. The second time, approval was less than a week. You can also call the # on the back of the card and they can tell you what the status is...I found out I was approved before getting the letter! Good luck!

[Sistergrl25 1]

I got a reply the next day!

[acadiamom 0]

The first submission was about a month, and although they said they sent a letter (a denial) neither my surgeon or I received it (and we STILL have not received it!). We found out just days before my surgery (which was supposed to be September 9th) when the surgeon's office called to find out the status. The surgery was cancelled and I've now filed an expedited appeal. Salome has given me some hope, though! I'll call UHC next week and see how the appeal is coming along....all they wanted was a letter from my PCP with a 5 year weight history and associated co-morbidities (which was kind of crazy based on what the surgeon sent in originally, but go figure....)

[lisw55 0]

Regarding UHC, does anyone have the APWU UHC Consumer Driven coverage? If so, can you tell me how to get a copy of the requirements? Is there a weblink that I can tap into to find the specifics. Thanks

[salome000 0]

Acadiamom...please keep us posted! I've got my fingers crossed for you. Of course, the approval is just the first part. I was excited until the damn hospital and doctor wanted 2500 up front...and this was AFTER I met my deductible this year and full insurance pay!

[acadiamom 0]

Hi everyone--I FINALLY got the original denial letter TODAY (the original request was submitted on August 18th and the denial was dated September 2nd)! My urgent appeal went in last Wednesday (the 17th). According to their letter, a decision for urgent or expedited requests should take 72 hours. I called this afternoon, but they had no updated decision yet. I'll try again tomorrow. Please keep those good thoughts going for me.....:redface:

[hersheymalone 0]

I know what you are going through.... I was denied by UHC the first time, then my doctors office submitted new info and I submitted my appeal. The medical director personally called the surgeons office and asked them for some info and left his cell phone # when they got the answers to call him. It only took 2 days and they finally approved it! What a blessing. I was exhausted and tired of worrying about it. I'm praying for you. It's so hard to sit around and wait on them!!!

[big_daddy 0]

Just got the call, I'm APPROVED!

13 days from submission, should have my surgery date by the end of the week!

:girl_hug:

[acadiamom 0]

Congratulations to BigDaddy!!! I'm happy to hear someone is getting approved....UHC denied my appeal. THIS time the reason was that I don't have coverage for any bariatric surgery. I'm beginning to think no one reads over there....they correclty quoted the coverage in my plan booklet ("page 58") regarding surgery, but the quote was from the section entitled "Other Covered Services and Supplies". Go figure!!! :crying: There is another peer-to-peer meeting scheduled today between my surgeon and UHC, but they've told me that UHC won't review any further appeals after this. I'm lucky in that my company has a Participant Advocate Group that intervenes when there are problems like this. They are now officially involved too, which means not only the dr is talking to UHC, but also a corporate representative. They want to ensure that UHC is honoring the contract that they are paying $$$ for. If I didn't already have hypertension, I sure would by now.....if all of this fails, my next step is an attorney....

[acadiamom 0]

lisw55--Check with your company's benefits department. The plan booklet should either be available on your company's benefits website or they can send you a copy.