deeteeceecee

hi Matt,

I just wanted to update you to let you know that I was approved...I didn't have a bmi of 40 for 5 years.

psjim2007

Hi,

By chance did you have United Healthcare PPO Choice Plus?
I hope I am approved fast and have the surgery before the end of November, my daughter is due to have her baby by November 30th and of course I will need to help her a little. It would be great if I could have the surgery by my birthday which is November 6th, that would be a great present to myself.

deeteeceecee

psjim2007,

I don't think my UHC is PPO...because I don't have to see a certain doctor. I can see any PCP I want.. My card also does not say PPO..sorry..

psjim2007

Actually when you have a PPO you don't need a refferal, you can see any doctor you want. That is how mine is, I didn't need a refferal to see my my surgeon. Actually I have in the past gone to a different doctor for a 2nd opinion in certain instances just to be on the safe side with no refferal. So if you don't need a refferal it is a PPO.

My cards doesn't have PPO on written on the card, but I know we have PPO because when my husband signed up for the insurance at work his company explained what PPO is.

deeteeceecee

Ok, thanks for leting me know..i was not sure..i got my insurance through my employer also..so i guess we have the same one..as i told mattr..i was only required to send in a 5yr weight history,bmi of 40 or more,and psych visit...so good luck to you.

Dragonfly

I had UHC and was very lucky - NO requirements of a special diet or diet/weight history or anything. And they paid everything but any co-pays I had. I paid a total of $500 up front for admin fees ($300) and $200 (nutritionist) but they paid everything else.

Good luck!

MattR

Today I went to my second visit with the doctor and I've run into a problem. When I called UHC about the requirements they said 5 year history, over 21 years of age, BMI over 40, and Pre-certification.

My doctors people are telling me I need to have a 2 year history, 21 years of age, BMI over 40, psych eval.

The problem I found out today was that now UHC is requiring a 6 month supervised diet that approved by Medical Technology Assessment Committee on Sept. 17th, 2009.

So far this is the only road block I've heard from my doctors people. So I called UHC and they said the only requirements were the ones they gave me the first time I called in early September. I mentioned to the rep the 6 month supervised diet and he said he didnt have that listed as a requirement. Should I have my doctor call the Insurance company about this issue? I got the rep's name and reference number to the call. I'm upset about waiting 6 more months. I want this to happen now.

poet_kelly

Ask your doctor to call UHC, yes. The doctor probably works with other patients who have other UHC plans that may have different requirements and is confused. You can also ask UCH to fax you the requirements in writing and take that to your doctor.

Kelly

__________________
RNY 11/4/08

surgery/current/goal
270/147/130

lvl0rg4n

So one rep is telling you that you do need a diet and one is telling you that you don't?

I would call and request to speak with a manager or something and have them fax you over the requirements.

__________________
lvl0rg4n says Morgan

10/27/2009 - Surgery day

Highest/Date of Surgery/Current/Goal
400/388/360.0/140

MattR

That could be the explanation. I'm going to call again tomorrow and see if they can fax me details about bariatric surgery requirements for my insurance plan. Once I have that information I will take that back to the doctor.