Help! Very distraught! (length warning)

I got a call from Susan at Dr. Murr's office. She said that authorizations does not want to send my file to United Healthcare because there is no sufficient diet history. Ok, well, My Dr didn't really want to help me much with that anyway and from what I understand, United isn't necessarily interested in that. She said that United is VERY particular (I have heard the absolute opposite) and that they would need that. She said that they could submit it the way it is but she is very sure it will be denied and that I should find out first what my appeal rights are with the company. So, I told her to hold the file so I can call my Dr and figure something out. I did that and I have an appt with him on Thursday. But that's not the main issue. I call United Healthcare's Care Coordination. I spoke with the nicest, sweetest woman. I told her how distraught I was, etc... First and foremost, it is a definitely covered benefit and she told me that all she needed upfront was any medical problems, height, weight, etc... She said that what she wanted to do was to start a notification of surgery over the phone. Ummm........ok. So I gave her my info. I have a notifcation number now. I am afraid that someone at the surgeon's office might think I am stepping on their toes. The rep told me that they will contact Dr. Murr's office and ask for any additional information. She had no idea if diet history was needed or not. BUT, she said that calling the information in is faster than faxing (which most Dr's offices do). I am on pins and needles. I want this to get approved without the diet history. Maybe there is no point to my rant, but I would like to know your views on this. Especially those of you who have United or Dr Murr. Help! I am freaking over here!

Hey! I have united healthcare and i am currently applying for dr.marema at us bariatrics. This doctor asked for doctor records with at least 6 months of showing my weight and attempted weight loss. I asked the lady who worked there and she said it is us bariatrics rule- not united healthcare. united healthcare just wants normal med records, height,weight,bmi, etc. So i think someone did get it mixed up at you dr.'s office. I think the problem may be someone that is misinformed there, not at the insurance. I would definatly have unit.health. call your dr.'s office. I hope this helps some. take care! Kim

Luckily they are supposed to call the Dr's office soon!

Marcie, I have United and Dr.Murr. I would not worry if Susan gets upset. She told you to find out your appeal rights. In the process YOUR insurance asked the questions and you answered them.They are calling Susan to get the rest of the information, I would not worry. Dr Murr is not going to change his mind about doing the surgery just because you checked with YOUR insurance as you were told to do. I would keep the doctor appointment and see if you can get the dirt information if you can. Hope you feel less stressed. gail

Yeah I am definitely going to keep the appointment with my PCP. I am not expecting much from him, but I am going to build a case on why he should help me.

I have United Healthcare, and they approved me without even seeing a letter from my primary care doctor. We got one anyway just in case they wanted it. But they never asked for diet history, or the primary care Drs letter of medical necessity, just the medical stuff, you know height, weight, co-morbidities etc. From the date on the approval, and the date I know the info was given to them, I was approved in less than 24 hours! Sounds like maybe the people in your surgeons are swamped with work and overwhelmed? Michele

Hey Lady, clam down. What is Susan going to do, bite you? Sounds like you have your act together and the insurance company will pick up ball and run with it. Do keep your apt. Good luck to you Marla

Good point Marla! I emailed her and told her what I did with United. All she said back was to give her the information I get from my Dr. on Thursday. I guess I shouldn't freak, but man she made me really mad!!

Michele, I have heard the same thing about United. I was really confused when I heard from the Dr's office that United is so difficult. All I have heard is good things about United. So I guess I shall see what happens. I am going to follow up with United on Friday or Monday and see if they had any luck with the surgeon's office.

I have heard conflicting stories about UHC as well, I really think it's whatever your policy indicates as being a factor. I know three people through my work who have the identical policy I do -- all three of them had to turn in diet histories of 6 months with their current PCP. One of the ladies was denied on the first try because of lack of documented diet history, once she provided that she was approved. Another lady was denied because her diet history wasn't with her current PCP but another one, she appealed and won. If possible, can you speak with any of your colleagues or husband's colleagues that have had this done and ask them what the exact requirements are? Either way, good luck!