Wells Fargo Employees - my path to approval

[tonyisstillhere 0]

I just wanted to share my story for all Wells Fargo people out there that may be struggling with approval or may not know the process. I made a few mistakes along the way, so hopefully you can read this and learn from it.

I started in November by going to the True Results (AIGB) location in Austin, TX last November. At this time, I was on Wells Fargo's Cigna Health Plan and was at aproximately 37 BMI. True Results did an introduction and the usual first step things and scheduled me for a sleep study to determine whether I had sleep apnea or not because under Cigna and most plans, you have to have 2 co-morbidities if you are between 35-40 BMI. It was determined that I had "mild" sleep apnea (which basically means they were interpreting the data in my favor to get me the surgery). After 2 sleep studies and multiple attempts to gather the necessary information through True Results, my case was dead in the Water. True Results, though helpful, were unable to help me move forward and so I dropped the issue for many months, feeling hopeless and helpless about my situation. After reviewing the different health plans the company offered, I switched to the Wells Fargo Health Plan (United Health Care Choice Plus Plan) because it seemed like much better coverage. In August of 2008, after gaining more weight and being close to 40 BMI I decided to seek help again.

This time, I came to this website and searched for Wells Fargo, United Healthcare and everything else I could think of that could give me answers on how to proceed. I posted questions asking for help and was lucky enough to get a response from a fellow Wells Fargo Team Member who told me all she did was call the health care company and they started the process for her and helped her through every step of the way to approval. I took her advice and started back at square one. I signed up for myuhc.com, which gave me online access to my medical history and to all the United Healthcare Resource Networks (urnweb.com).

From there, I submitted a request for information and for a phone call from a bariatric patient advocate. From that moment on, the process was smooth. Not always simple, but I had a United Healthcare representative personally working with me the whole time to help with the what she needed to issue an approval.

If you work for Wells Fargo and want Bariatric Surgery, GET THE WELLS FARGO HEALTH PLAN (UNITED HEALTH CARE). It is the most expensive plan they offer, but it's worth it for the way you are treated and taken care of. Follow these steps and you'll be fine!

1) sign up for myuhc.com. request access to urnweb.com and visit the obesity section. review the "united healthcare centers of excellence" link. UHC requires you to use one of their "centers of excellence". these places have the lowest rates of problems with surgery and have undergone rigorous review to achieve this rating. united resource networks is also called "Optum Health".

2) submit an online request through urnweb.com to be contacted by a patient advocate. it took about 2 weeks for me to get the call. my advocates name was faith, and she was incredibly helpful.

3) the patient advocate will help you choose a center of excellence. they'll have you go to one of the orientations, where you'll meet the surgeons and staff and have all your questions answered.

4) you'll then be working in conjunction with the surgeons office and your patient advocate with UHC to get all the necessary documentation in place for an approval.

a few things to expect:

-a psychological evaluation (your advocate will help schedule this). my out of pocket expense for this was $80.

-an appointment with a nutritionist. my out of pocket expense for this was $150 and it was a requirement of the surgeon, not UHC.

-you may be getting phone calls from several different parties through the process. everyone who called me was super helpful and friendly.

i hope this is helpful for someone out there. i'm happy to say that i've just recieved approval and have surgery scheduled for 12/16/08 with Dr. Keith Wright of South Texas Surgeons in San Antonio, TX.

[tonyisstillhere 0]

update 12/21/08

i had surgery on 12/16 and everything went well. united healthcare continues to be top notch. i receive regular follow up calls from the Bariatric Nurse in charge of my case at OptumHealth (United Resource Networks). my total out of pocket so far for the surgery is about $1700.00 (and my maximum is $2000). i am sticking with united through this whole process!

[Aggie98 0]

Glad everything is going to well for you!

Did you have to pay the $1700 before the surgery or did your doctor bill you for it?

[tonyisstillhere 0]

the hospital took a credit card payment pre-op

[tonyisstillhere 0]

update 1/14. i received a bill from the hospital for over $6000, but sorted it out with United Healthcare with one call. apparently the hospital overcharged me when they made me pay $1700 and they should have only charged me $800. i'll be calling the hospital in the morning to get my money back. once again UHC has proven to be a great resource and advocate. none of the horror stories i've heard about their service have applied to me!

[Halie123 0]

I too am with Wells Fargo in san Antonio,tx.I have been researching lap band for yrs. I am fully focused and just discovered the anthem bcbs I have allows for one bariatric surgery per life of insurance. I'm worried because my current family doc is all about alternative weightloss. I have been between 37-40 BMI for 6 yrs with 2 co- morbidities. Where do I begin? Help!