United Healthcare : Freakinnnggg Outtt!! - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

ItsDev! · 06-24-2009, 02:15 AM

Hi everyone!! I'm new to this site, and I'm soooo darn excited to have found such an awesome forum where everyone seems to interact with so much sincerity, enthusiasm and compassion. I can't wait to be further along my WLS journey so I'll have more insight and news to talk about alongside everyone!! The following is an intricate combination of venting/ranting/request for advice, so if you'd like to skip the dramatics I've colored the "bottom line" of my posting in green.

My question right now is to anyone who has ins. through United Healthcare PPO Plus (ideally in SoCal perhaps??)

Here's my sitch: I met with my surgeon for the first time about a month and a half ago at a Lapband informational seminar at a WLS/Plastic surgery clinic called Beverly Hills Physicians and when I had the chance to speak with the doctor privately, he agreed that gastric bypass would be an acceptable option for me if I preferred it, which I do. So the same day, I was weighed and measured, and within the next week I ran around like a crack-enhanced soccer mom to have my endoscopy, EKG, psych eval and blood tests taken care of. After that, I was directed to talk to the doctor's assistant for further guidance and this is where the freakout begins. This assistant of his has had my paperwork for just over three weeks now, and unable to control my enthusiasm (which to the uninformed observer may or may not resemble maniacal hysteria) I've been calling the poor girl on a daily basis for status reports. The reason I feel the need to do so is because every time I speak with her, she tells me that she has been unable to do absolutely anything with my file thus far. The first week, she said it was because she had yet to receive my 5 years of medical history from my PCP, so I called them, had them fax it, the assistant in the surgeon's office still couldn't seem to get her hands on it so I hand delivered a copy.

Next she says shes missing a whole lot of paperwork I was supposed to sign and she couldn't find the forms she needed to fax me, and she wouldn't be able to submit my case until she had it signed. A week later i finally get it in a fax only to find that this "massive, obscurely hidden load of unsigned paperwork" was a frickin release form to have my med history faxed over from my doctor WHICH SHE WAS ALREADY IN POSSESSION OF AS I HAD HAND DELIVERED IT (I mean, are you freakin' KIDDIN me?!) and now every time I call her to ask if she's submitted my paperwork, she says "Call back tomorrow, it should be done then" and it never is. I spoke with the doctor (and because he is a very well recommended surgeon and because I like his "pizazz," I'm hesitant to switch to another facility) to let him know about the ridiculous amount of time that had been wasted by his assistant, and he promised my paperwork would be submitted by Monday of next week (June 29th.)

So now, it's just the waiting game, and it has me completely nerve wracked. It's literally all I can think about, From the moment I wake up til the moment I go to sleep, and even then I DREAM about it. I can barely sleep, I can't eat (ok, I can eat but under moderate protest) and it's all I can do to keep from looking up the addresses of UHC approval deciders to knock on their door equipped with complex pie charts and visual aids to show them how approving me for this surgery which I desperate want and need would officially make them the indisputably most awesome heath care provider on the planet. What I'm worried about are the requirements associated with my plan (PPO Plus) because my insurance (which I have through my step-dad) will expire on my 22nd birthday, 4 months from now and if they require 6 months of supervised dieting or excercise I'm guessing it's a safe assumption that I'll be S.O.L. by the time I'd be officially approved for WLS. Can anyone share their experience with UHC, especially PPO Plus plan holders, as to how much waiting time/requirements they are most likely to require?? I've got my hopes so high right now that hopefully they won't require the supervised dieting but I really don't know what to expect and it's completely wracking my nerves.

Thanks in advance for your input. =) Any advice on the matter at all might help me relax a bit.

Ms. Readytobehealthy · 06-24-2009, 02:37 AM

Welcome to TT family Dev and yes you are correct that there's alot of folks on here that are positive and motivational. I do have UHC PPO plan and my paperwork was just submitted yesterday, so we are in the same time frame for paperwork submittal. My UHC plan did require a 6 month supervised diet but that strictly goes by your employer. I know some folks that have UHC at another employer and they did not require the 6 month diet. I would recommend you call the insurance company directly and they will give you the criterias for your fathers employer over the phone. Maybe we can stay connected and become TT buddies. I am hoping to get approved and have a date in July. If you have anymore questions just let me know.

Ms. Ready

ItsDev! · 06-24-2009, 02:46 AM

holy mackeral, what a quick reply!! you are FANTASTIC Ms. Ready, thanks for taking your time to help me out.

I'd love to buddy up, it's so exciting that we're on similar timeframes. I didn't know that the employer is what makes all the difference, I definitely will call UHC in the morning to get the lowdown. I think I can finally sleep tonight. Again, you are FABULOUS!!! Thanks so much!!!

!!

Ms. Readytobehealthy · 06-24-2009, 03:27 AM

Quote:

Originally Posted by ItsDev!

holy mackeral, what a quick reply!! you are FANTASTIC Ms. Ready, thanks for taking your time to help me out.

I'd love to buddy up, it's so exciting that we're on similar timeframes. I didn't know that the employer is what makes all the difference, I definitely will call UHC in the morning to get the lowdown. I think I can finally sleep tonight. Again, you are FABULOUS!!! Thanks so much!!!

!!

You're welcome!!! You will get plenty more responses once folks wake up. I am up now because I can not sleep. (lol) All this excitement about my paperwork being submitted already and with the GRACE of GOD I am actually seeing progress. Well let's keep in contact and let me know how it turns out.

Ms. Ready!!

Vikkator · 06-24-2009, 07:00 AM

Hi Dev,

I had UHC PPO Plus too and I believe it does depend on what your employer requires. You should call UHC directly. Just an FYI, it took them about 2 weeks to approve me after the paperwork was submitted. I've been very happy with the way they handled everything and I ended up paying about half of what I expected out-of-pocket.

You might want to light a fire (again) under your surgeon's assistant and let her know of your impending loss of insurance so you can get this done. Hopefully, you won't have to wait long.

Good luck.

adagirl · 06-24-2009, 12:30 PM

Just want to reiterate, definitely let the surgeon's assistant/insurance person know about the timeframe concern and your insurance expiring. This may get you a higher priority and faster track in their office, maybe even get your paperwork handled by a higher up person (if they have more than one insurance coordinator in their office). They won't want to lose your business and you deserve to get this done while you have the insurance to do it. Best of luck to you!!!

suebry05 · 06-24-2009, 02:30 PM

I too had United Health.. and was not required to have a 6 month diet for approval- I had it anyway as I was truly at my last hope of losing it on my own. But each company requires different things....call your insurance company and just ask. I was approved in 10 days after it was submitted.

good luck!!

LyndasRoom · 06-24-2009, 03:28 PM

Hi Dev,
Welcome to TT. You've received great advice. Check with UHP to see what their requirements are. USUALLY, the doctors offices are quite familiar with the prerequisites are, and you would not have had a referral to the surgeon, had you not met them. I personally would back off the lady at the docs office, and give that attention to your insurance provider with your questions. Is there anyway you can remain on the insurance? Another semester of school perhaps? In the meantime, there's tons you can read here, it will take up time, while you wait...and ease your nerves and fears a bit.

ItsDev! · 06-24-2009, 05:56 PM

Thank you all SO MUCH for your support and advice, I called UHC this morning and found out that under the company's coverage i will NOT be required to do the 6 months of supervised dieting, so basically once I'm approved I'll be able to schedule my surgery right away. WHEW what a load off my mind, I'm so relieved and excited!!!!

suebry05 · 06-24-2009, 06:50 PM

thats great news!! good luck- and yeah- I would try not to badger the women too much as she may get pissed and drag her feet...