UHC won't give me my benefits and WLS requirements for 2012 - argh!

sarapilar
on 12/21/12 1:30 am
VSG on 02/21/13

Has anyone who is trying to get WLS through UHC had this problem?  They say 2013 plans are not loaded into the system.  I mean, we can put a Man on the Moon, but we can't load this info 10 day before a New Year?  Anyone else?  Any advice?  I have gone to HR and all they have is the Medical SPD.  They've sent me back to UHC....

"The most difficult part of changing how you live and eat is believing that change is possible. It takes a fierce kind of love for yourself."Geneen Roth
    
sweetangelmd37
on 12/22/12 8:50 am
I have UHC and I am getting mixe messages. Was originally told no 6 month diet and no Psych evaluation. I was then told I needed both. My surgeon sent in documents as they were told, only consultation and 40 plus BMI. I spoke with UHC and they received documents on 12/17 and it is pending. I am praying I get the approval call.
sarapilar
on 12/23/12 9:43 am
VSG on 02/21/13

I know?!  It is infuriating.  And so frustrating.  Good luck, Keep me posted!

"The most difficult part of changing how you live and eat is believing that change is possible. It takes a fierce kind of love for yourself."Geneen Roth
    
loggergal
on 3/30/13 5:45 am - Felton, PA

I had a similar problem with UHC when I looked into getting requirements from them back in July.  No one could answer how many months of nutritional classes I needed, or any other requirements nor could they refer me to any approved providers and I called several times and each time with a different person.  How is it that their representatives don't have the information you request?  Their representatives should have a cheat sheet on this stuff by now.  Any way, I went ahead with a program close to me because it seemed like most insurance companies require 6 months ($20/mo) plus copays for the specialist consults.  I completed everything, including all the consults and got the call today from a nurse at Optum Health Care who said I completed everything they require except for going through an "Optum" Bariatric Center of Excellence so they would have to DENY my claim but I could appeal.  

I knew the one in my local area said they were a Center of Excellence but I did not realize this is NOT a standard classification.  Each insurance company has their own set of standards apparently.  How was I to know that when UHC couldn't even tell me their requirements or even refer me to the 3rd party I was to apparently supposed to use?  UHC's plan through my husband's employer uses a third party, "Optum Health Care Bariatric Resources to verify and approve all their bariatric surgeries. I was in shock for them to deny me only because I didn't select a center of Excellence approved by them nor could they tell me if I could just go to an approved one without going through the whole process again.  They said that decision would be up to the surgeon.  REALLY!!??!! blush  Let me tell you, I cried and cried, screamed, cussed and screamed some more!!!  I have to fight my tears typing this now.  I have spent a lot of time, money, and effort to lose weight to only be told I didn't follow the proper steps but how can I prove that I was not given the proper information from UHC?  I only hope someone has the common sense to allow me to go through their Center of Excellence program without starting over the whole program and consults. I can't wait until Monday morning.  You know I will be on the phone on Monday morning with all involved.

 I will post what I find out for any of those who might be in the same position.  Please keep your fingers crossed.   I basically had to go through trial and error but I guess they want us to not be successful so they incur more costs!  That's all for now.  Sorry to vent so much. 

I hope you finally received the information you were looking for and are on the right path.  

Most Active
×