PATIENTLY CHECKING IN

Hi everyone. I'm not one to post here a bunch but I though that I would just chime in and say Howdy...I'm a pre-op DS Patient of Dr. Simpson in Phoenix and am just patiently waiting for my insurance approval from United Health Care. They've had all my paperwork since the end of November and are just taking their sweet time. Best wishes to all..........

Hi Dennis, I had approval back from UHC in approx ten days. Of course, every situation is different but have you checked with Dr. Simpson's office to make sure the paperwork got filed timely? Some doctor's offices need more "prodding" than others. I have no knowledge either way of whether Dr. Simpson's office does or doesn't...just making a suggestion. Good luck! Tammy

Hey Dennis, I am also waiting for Dr Simons office and I have United Healthcare (Choice Plus)...but I am still waiting for some medical records to come back from another office...it is just a big waiting game sometimes but you have to continue to check and call and bug people to find out where you are. Don't ever give up...Christina

I had UH****il Dec 31 and they had an exclusion for WLS. I am so glad my company changed and I am now covered. Now moving full-steam ahead.

Hi Joy, Just want to clear up a misconception that might occur to some pre-ops out there considering WLS.... UHC itself does NOT have an exclusion for WLS. Employers contract with insurance carriers and employers pick and choose what will/won't be covered. UHC is actually one of the best in terms of approving WLS as long as the employer itself does not exclude it. Because UHC is one of the better coverages out there, it is also one of the more expensive ones to employers. Therefore, employers will often choose to eliminate some procedures, meds, etc. in order to keep their cost down. So it appears that this is what happened with your employer who chose to exclude WLS as being covered. That's great though that they've now offered you a plan that does allow for WLS coverage! Good luck to you! Tammy

I have no misconception. It was not covered and this plan we have now does, my company did not choose not allow it from UHC, I asked, that is the plan they affered. Now we have been offered another plan and again we got what they offered, my company did not choose to cover it now and not before. I understand that some do that, but that is the way the two offers feel together.

Hi Joy, I didn't mean that you had a misconception. I meant that someone new who is pre-op reading the message board may have read the original message as meaning that United Healthcare does not cover WLS, that it excludes it. I was just attempting to prevent anyone from developing that misconception. Each insurance company offers coverage either ala carte (employers can pick and choose what they want in it/not in it) or an employer can pick a package deal that the insurance company offers. Either way, employers choose what they think they're getting the most for their money but bottom line is, the employer wants what is usually the least expensive to them. As a human resources manager, I've been in on way too many of those discussions for my personal tastes as they can get quite "testy".

Welllllllllllll........I talked with the Surgeons (Dr. Simpson in Phx.) office today and it appears that United Health Care does not know where my paper work has gone to, sooooooo the new stuff was being re-fax to UHC today. I'm sooooo patient, after all it's only been 45 days or so waiting for the approval that should have come in 3 days. Thanks all.......:o(

Good luck Dennis....keep us posted!

Sorry you're in insurance hell right now. I was there for 3 months and it was definitely the worst part of this entire experience. My doc's office would say they had sent the info, but Cigna would say they had not received it. Back and forth I went, like a stupid ping-pong ball, for three months. Finally found out my docs office had experienced an entire staff change out and had lost my (and several others) files! ARRGHHH! In the end, I located someone at my docs office who had a clue and hung on to her for dear life! Best of luck during this time, and going forward.