Guest guest Posted March 3, 2000 Report Share Posted March 3, 2000 Hi. I don't have United Healthcare, but I have been denied twice by my insurance company. I filled out an online form at the Insurance Commissioner Website for my state about three days ago. Today, I got a postcard in the mail from them saying that they were investigating the claim, and that they did not need any additional information from my unless they ask for some. They said that they would get back with me as soon as they investigate the claim. They even have lawyers that they use at no cost to the consumer. They cover ALL insurance companies that sell insurance in your state. They issue licenses to the insurance companies, and I'm hoping that they can help me. You might try contacting them. ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2000 Report Share Posted March 3, 2000 Thank you and Stormy for the info. Sue sen future MGB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2000 Report Share Posted March 3, 2000 Good luck Beverly! Have a safe and uneventful surgery! Thank you for the additional information. I am in the process of trying to get approved through United Healthcare. I am crossing my fingers, but have contingency plans in the works if they give me any guff! I think the internet is a wonderful place to meet great surgeons! :-) fg At 04:19 AM 03/04/2000 -0000, you wrote: > > >Hello everyone. My name is Beverly and I have been " lurking " the past >few weeks, but today I got my approvel from United Healthcare. I have >been reading all the mail everyone posts and it has been helpful. >Everyone keeps saying to fight the insurance companies and I agree. >United first denied me a couple of days ago but I got on the phone >and started callling. Finally found someone who would talk to me and >explain just what they needed for " medically needed " . Even though I >am not having the mgb, this site has been very helpful. I'm having >my surgery done in Florida, Daytona Beach because I need a revision >and though the internet found a surgeon in Ormond Beach who does this >kind of surgery. They even have a support group. But back to >United-they approved me within hours after my doctor's office talked >to the " patient review " and explain my case in detail. My policy >does have an exclusion, unless medically needed. So hang in there, >also dranonymous.com is an excellent site. It's well worth the $7.95 >to download his handbook on insurance companies. Hope this hasn't >been too long, rambling. Thank to everyone and good luck. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2000 Report Share Posted March 10, 2000 Hi just thought i would let you know that i was approved and had the surgery on Dec 13, 1999 and had united health care and they paid everything except 14.00 Dee in Missouri Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2004 Report Share Posted February 21, 2004 Felicia I also have UHC. Co-workers of mine, all w/BMI over 50, were also denied on first request. It seems to be routine. You may want to call the member 800 number on the back of your card and ask for Care Coordination. They are the ones who approve/deny requests. I had a good experience talking to them. They DO need letters of medical necessity. Im glad I called ahead. I listed all my co-morbidities (diabetes, hypertension, sleep apnea, high cholesterol, acid reflux, joint pain from back and knee surgeries, stress incontinence, plantar fasciatis, varicose veins); listed all the rx meds I hoped the surgery would eliminate (insulin, glucotrol xl, glucophage, cozaar, lasix, potassium, lipitor, celebrex, nexium, raniditine) and the hopes of reducing my risk for stroke, heart attack, blindness, renal failure and other diabetes related disorders; adding expected resulting benefits (endurance, pain reduction, appearance, self image, overall better health). My BMI was only 37 and I was approved in a record 48 hours. The more you can lay on them, the more you show you want this surgery for health reasons and not cosmetic reasons. This will also help your surgeon's staff present a complete case to UHC for you. UHC also wants to see a history of previous diet attempts. Put on your thinking cap and go way back. Dont omit anything. I began with 'remember metracal in cans in the late 1960s-early 1970s.' I listed every attempt at weight watchers with approx dates, if only the approx year. I listed every time I talked a doc into diet pills, every time I tried to lose weight. If you or anyone wants to see my attachments, email me off the list and I will be glad to send them to you. Anything to help. Now, on the downside, I read an article in the Palm Beach Post 2 weeks ago that said UHC, Humana, Centra all discontinued coverage for gastric bypass and that Blue Cross Blue Shield of Florida would discontinue in January 2005, and that Aetna was the only insurance company still approving coverage. The link in the paper was only good for 7 days without paying for an archived article, but I saved it. Again, anyone interested can email me off the list. The reasons were purely economical. I only hope they dont become liable for risks involved from not having the surgery. On a side note, I found and saved a link for future use. It is a compilation of appeal letters to insurance companies covering everything from the WLS to plastic surgery. http://mygastricbypass.com/appeals.htm I hope this helps you or others. Do not give up; but do not go in unprepared. Be Well ~~Pat~~ 252/209/160 Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.