Bummed about UHC...

My surgeon's office called late last week and gave me some disappointing news. She said that I would have to provide a 5 year weight history, and that I would need to have been morbidly obese for the last 5 years. Does that make any sense to anyone????? I've been heavy for the last 9 years, and been morbidly obese for the last 2 1/2, I can't wait another 3 years to get this surgery..... Alli

Here is what I did and it worked....I obtained Dr. records from the last 6 years and wrote a detailed history of my weight loss attempts, conversations that I had with Dr.'s and etc....obviously it took a little bit of time to compile the information.....but the insurance company was helpful to me in identifying all my Dr.'s from the last 6 years...since I have moved often...had many to contact. Once I got all that information compiled I forwarded to SBC and they were able to make things work. I wouldn't give up. Best of luck, Dave 411/202/170

I'm not giving up, I was just hoping that for once, something could be easy for me. I've had several friends at work who live in NV, and had no problems getting approved, so I went to a seminar in LAS, filled out all my paperwork, and was going to have surgery out there since Dr.Blackstone is so backed up with everyone leaving her office. My friend was had his surgery 3 weeks after he started the process, and I was like "GREAT", if I could get my done before the end of the year, and be on my way to getting healthy, it wouldn't be the greatest Christmas present I could get. So I'm more than a little upset that this process is not going to be an easy as I thought. But in the long run, being overweight isn't easy either. I struggle every day just to do things that other people take for granted, so I will not be discouraged by this setback! I will fill out every single piece of paperwork that is needed, I will submit knowing that it will probably be declined, and appeal until I have no options left. This is my life, and I won't back down on this!!!! Thanks for the encouraging words Alli

May I ask if you have any co-morbid diseases? High blood pressure, diabeties, sleep apnea, or dis-order, I am sure there are more. Good luck and indeed do not give up! Why they would want you to be heavy longer is beyond me, maybe they suspect a plot where there are people out there who are getting fat just so they can have WLS.

I am with David... ask your current or previous doctors for your medical records. Maybe I have your doctor compose something of your weight and attempts. Fortunately, I had documentation of my attempts with Jenny Craig and Weigh****chers from a few years ago all the way back to 1995 and Weigh****chers from when I was a teen. I do not have any co-morbities like diabetes, HPB, sleep apnea, etc... so I was expecting alot of problems with the insurance company and the only thing they required was Letter of Medical Necessity and 6 months of supervised weight loss. Even thou Dr. Blackstone's office is going thru some changes, I personally think she is a great surgeon and I think the program is well worth it. I understand your anxiety to have this done! But, right now it seems like they are scheduling in mid-November now and with the holidays, I would had to have surgery around the holidays! Good Luck to you!

That Surprising, I have UHC and the only requirement I had was to be 100 LBS overweight or a BMI over 40. If under 40 BMI then 2 co-morbid. I would call UHC and ask then their requirements. Just a thought. Good Luck and don't give up Lamont

Hey Alli, All you have to do is get a letter from your doctor stating you have been morbidly obese more than 5 years. I got one from my old general health dr and he was happy to write it for me. Faxed it right over, UHC is great!

Hey Alli, I was denied by State of AZ UHC, they said I needed a sleep study and I had one booked two days later and have sleep apnea. Dr. B's office didn't even know they needed this BEFORE submission. I called the "CARE COORDINATION" Department of UHC and got my reference number and faxed away the results, they approved me by letter a few weeks later. Keep trying they are supposed to be one of the better insurers for approval. I got all my old dr's records with my recorded weight on them, maybe get your gyn records every year if you don't see your internist regularly, I did several months with Dr. Emmerschad before they stopped the 10% lost requirement, she's great. But I also copied all the diet books, THEY'RE COVERS, tapes. WW books, OA newletters, anything I spent money or time on and send in to SBC. So don't give up!!!! DON'T GIVE UP!! Maybe I'll see you in the hospital this fall!! Katie

Alli I was told the same thing by Freda and I am sure she was told that by UHC's pre authorizations people. But I just told Freda that "no" I don't have that, she called me a second time and told me that they were asking again and I once again replied that "no" I don't have that. I also called UHC Care Cordination and asked them and they said it isn't "required" but they do ask for it across the board with everyone. I just told Freda to submit it and if it is denied I will deal with that at that time. But UHC Care Cordination people also said that it didn't mean that I would definitely be denied if I didn't have it. So then I called back to UHC about 3-4 days later and they said I was APPROVED!! I would just keep at SBC and UHC and don't give up!!! Good Luck! BTW my date is 2 days before Thanksgiving so I will have a LOT to be thankful for. Cathy

Cathy, thanks for the info. I feel a lot better about the situation now. I am going to the seminar on 9/10 @ SBC, and hope to move along quickly in this process. It's so great that you are already approved, and have a surgery date. My goal is to get approved and be a "LOSER" by the first of the year......... Alli