Is this too easy? - Page 3 - ThinnerTimes

Mavisavis · 01-22-2008, 06:35 AM

Sounds about like what mine required. Just make sure you give them as much as you can as documentation right off. Good luck!

smurfswifey · 01-22-2008, 07:27 AM

I finally got throught to someone who had more info for me at the insurance company. The person I talked to told me they require: height, weight, bmi, any co-mobitities,5year history of being obese, what non-surgical approaches I have taken to lose weight(but nothing about it having to be dr. supervised??), and a letter for my dr and surgeon. That really doesn't sound like to much! I was sooo happy! I know it is alot more than it probably sounds like, but I have heard so much about how insurance companies make you jump through hoops and mine doesn't seem to be like that. Hopefully it all works out good. A nurse is suppose to be calling me from UHC to talk to me and get more info either today or tomorrow. Does anyone know why they have nurses call from the insurance company??

rappaport · 01-22-2008, 07:39 AM

Quote:

Originally Posted by smurfswifey

I finally got throught to someone who had more info for me at the insurance company. The person I talked to told me they require: height, weight, bmi, any co-mobitities,5year history of being obese, what non-surgical approaches I have taken to lose weight(but nothing about it having to be dr. supervised??), and a letter for my dr and surgeon. That really doesn't sound like to much! I was sooo happy! I know it is alot more than it probably sounds like, but I have heard so much about how insurance companies make you jump through hoops and mine doesn't seem to be like that. Hopefully it all works out good. A nurse is suppose to be calling me from UHC to talk to me and get more info either today or tomorrow. Does anyone know why they have nurses call from the insurance company??

The company I worked for had a nurse assigned to me throughout the process, making sure I was progressing along, providing me with hints and tips to watch out for before, during, and after the surgery, and to be there as an advocate if I was having issues with anything. While I didn't have anything eventful happen, she did provide me with a lot of tips that I did not learn in any of the seminars I attended.

twodogsmom · 01-22-2008, 10:26 AM

Mine went very fast, too. Just make very sure you are emotionally ready for the huge changes this will make in EVERY aspect of your life! An eval with a psych who is familiar with GBP, even if not required is a good idea since she can help you realize all the ways your life will change that you may never have considered.

smurfswifey · 01-22-2008, 02:16 PM

The surgeons office just called to remind me of the seminar on thursday...how could i forget..lol. Anyways, the person I talked to is the person that submits all the papers to the insurance company. She told me based on everything I told her, and the fact that I have UHC and the plan that I have I should be no problem to get improved. I was so stoked when I heard that. I am just worried all this good news is going to end with disappointment somehow. And she did mention that even though UHC didn't say anything about a psych exam that it is something that is required, so you were right . Thanks for listening to me ramble. It really is kind of nice to be able to talk to people that are going through, or have gone through the same things that I am experiencing right now.:

szmalik · 01-28-2008, 06:42 AM

Quote:

Originally Posted by Momof3

Ok, I just started my journey to having gastric bypass surgery. I went to the required seminar at the surgeons office and turned in all my paperwork. They contacted my insurance carrier who in turn sent back a list of requirements. All they require is written release from my primary care physician stating I'm healthy enough for surgery, my height weight and BMI for 5 years, 36 months of documentation showing conventional attempts at weight loss and a psych evaluation.

I had my consult last night with the surgeon, at that time he gave me the requirements my insurance company sent them...

So, I went to my PCP today and he printed off all their requested records. He wrote a very detailed letter, outlining my medical conditions, as they requested, and attached all the test results and BMI history.

I have my psych eval appt scheduled but it's not required to get approval.

I had 3 things on my required list. I got them all, and them some.

Am I going to be hit with some big surprise or could it really be this easy?

I'm in the morbid obese category, my PCP says I HAVE to get this done....

what say ye? Should I get my hopes up?

Is it possible to have it all done in a month? UHC said they will let us know within 14 days.

Am I dreaming? Should I be expecting them to continually come back with more requirements?

no, you shouldnt wait for the other shoe to drop, if you read my post, it took less than 2 months from the time i went to the seminar to get approved, maybe like 6 weeks, like you, i had all my paperwork done quickly and had the psych consult, and after reading about how other people are having such a hard time with there insurances, i feel blessed and lucky that everything went smoothly

szmalik

Mavisavis · 01-28-2008, 08:19 AM

Quote:

Originally Posted by szmalik

no, you shouldnt wait for the other shoe to drop, if you read my post, it took less than 2 months from the time i went to the seminar to get approved, maybe like 6 weeks, like you, i had all my paperwork done quickly and had the psych consult, and after reading about how other people are having such a hard time with there insurances, i feel blessed and lucky that everything went smoothly

szmalik

Mine was similar....consult was June 10th, approval July 18th, surgery Sep 7th....and that's because they only had one surgeon skilled in doing it laproscopically, or it would have been way sooner. I did also have a good insurance company, submitted proof of past attempts, and did a lot of fancy footwork getting appointments in and results turned in.....but it can happen.

billiejo · 02-04-2008, 04:55 PM

Wow Jim...I was reading your reply and I had cigna and got turned down!! My employer switched to UHC and I am hoping to submit for approval this week...

I have everything...6 months nutrition...pcp letter....psyc eval....5 yr. wt. record...went to center of excellence on friday of last week and the Dr. was like....holy cats woman...you are ready for sugery....but I need to get the sleep study done and i want to do 2 more nutrition visits (just a refresher for myself)...then i need to lose 10lbs and off i go...i talked to my nurse coord. today and she said she will put me on the schedule for April!!

Question for you....when you submitted for approval...how long did it take and if you don't mind me asking what company you work for....I work for a national company so just wondering if by chance we work for same company (just due to the cigna and now UHC?!) Would be kinda neat...

SeptemberDay · 02-05-2008, 04:06 AM

I have UHC PPO and I wasn't required to do anything really. I did the seminar and psych eval just for me, but UHC didn't even ask for my 5 year history. But both my doctor and the hospital I'm using work within the UHC network and I'm guessing that has a lot to do with it. I'm told that this is a $25,000 surgery but my doctor's letter states that it's only $7,500 and was told that surgeons and hospitals that work with UHC give lower prices. I don't understand most of it, but I'm sure happy about it!

presentationmall · 02-08-2008, 02:19 AM

Quote:

Originally Posted by Toony

Hi Mom~

I hope things go that easily for you... no mention of a six month supervised diet, huh? That's lucky. As much as I whine about the waiting... it's been a good time for me to research, meet with others and try to make changes in my eating habits now. Hopefully that'll make transition into tiny-tummy world easier on me!

Keep us posted... I'm excited for you!

katie

Thanks for your information.