Help! Very distraught! (length warning)

I can't say enough about United Healthcare and the way they handled my approval and surgeon's payments. You might try approaching your PCP by just asking for a letter stating your recorded weights and that your health would benefit from weight loss. Like I told someone else this evening, don't let the doctor's office staff take away the relief from being approved. It's your life, Right? Good luck. LuvitsunnyV

Well, my PCP did write a letter explaining that he recommends me for surgery and such. I mentioned to the coordinator that maybe I could get a letter from him stating the work we had done on my weight loss the past 6 months. She flat out told me that a letter would not be accepted at all and that they need 6 months of documented information and also showing that I went to the Dr each month for weigh in. I guess I will see what UHC has to say!

First I want to say that I understand what you are going through! I, too am a patient of Dr. Murr's and I have United. My file got held up for the same problem and I did exactly what you did by calling the insurance, talking to a very helpful lady and doing a notification of surgery by phone. I got specific instructions on what the insurance wanted and what the office needed to do next and all they needed to do was make a phone call. Then United would determine what and if they needed any paperwork or files. This was because this was a covered item on my plan. Susan and the insurance gal at the office could not get it through their heads that this was first hand information from the insurance adjuster herself. She just kept telling me that there were procedures that had to be followed. I tried explaining that not all insurance is alike. But I guess she was too busy to deal with me. What could have been done in a matter of a day or 2, took a week or 2. I feel like my file was held back from being sent because I got "Involved". I know it sounds silly and maybe petty, but I am hearing more and more of this and I really hope that the office gets themselves together. Dr. Murr is a great surgeon and I stand behind him 110% but something has to give with the office staff. We are stressed enough as it is, and we could use more "friendly customer service" and attention especially when we have questions. OKAY, I have vented enough. Hang in there. I know the ropes are long in some cases but the rewards are just around the corner! Kathy

Ok, my turn to say something about the office staff at Dr. Murr's office. I don't have UHC however it did take almost two months for Dr. Murr's staff to turn my file into Aetna. And two weeks later I was approved. However I would like to say that I am SOOO glad that Susan is atleast calling you all with insurance issues. I have pnuemonia. And I called Susan, Dr. Murr's office as soon as my pcp called with the X-ray results. So that way everyone was on the same page and to see if Dr. Murr wanted me on additional meds. Well, that was last Thursday and I still have not heard word one from the office. Oh well. Karee

Ladies!!! First of all....I totally understand how frustrating dealing with Doctors and Insurance companies can be....especially when "we" have decided to go full throttle with having this surgery. Let's remember.....there are 100's of us at any given time trying to get approval w/any given Dr. Think about how many people were sitting at the Support group meeting when you were there. As you should well know Dr. Murr's staff is shorthanded right now and Susan is doing the job of 2 people, I know for a fact that she has been pulling 12-14 hour days....so let's cut her some slack!!! Susan has been given a set of "protocol" that she probably has to follow for each patient...and I am sure she is "doing her job". For each person that tells her the 6 months of dieting isnt a requirement...how many people are just trying to see if they can blow by the insurance company??? When I was going through the approval process, I too had to get a letter from my insurance company stating it wasn't required. Please...when you post something so negative about a Dr. or his staff....realize the impact it could have to his practice....their are thousands of people each day that could be checking out these boards...see your post, and decide based on what "you" have written to choose another surgeon. Personally...Dr. Murr and his entire staff have been wonderful to me, and if it meant waiting an extra few weeks or even months, I would gladly have given them the time, then possibly have chosen a less caring or competent Dr. Just my two or three cents worth. Lori 222/157/1?? laprny 1-6-04

Lori, please don't misunderstand!! I can absolutely say more good things about Susan than negative things. For example, she is incredibly quick at responding to emails and she has been nothing short of helpful with me. It was just today that I was really kinda freaked because I thought everything was fine. She did offer to have them send everything through without the diet history but I was just a little taken aback when she said that they would probably deny it. I am extremely happy that I am dealing with Dr. Murr and his staff. I wouldn't have it any other way. I started this journey back in January and although it has taken awhile, it has been completely worth it. I don't want to ever give the impression that I have something negative to say about Dr. Murr or Susan. I am just venting my frustration on the situation.

Some people dont visits certain Drs for many reason. For some.. it's disorginazation... it can be unstaffed, chaotic, dirty, smelly, or just someone having an attitude problem. if the office is short staffed, and it's causing this many people grief, people have a right to know so they can avoid the headache that goes along with that surgeon. If I had heard from as many people here that my Drs was unorganized and caused this much grief.. I'd have changed surgeons too. Luckily, that wasn't the case. There is nothing wrong with a compaint against a Drs office being posted, as we all the right to be informed about EVERYTHING that will directly affect us.

Hi Marcie (and everyone else) If I can add my two cents from a different Dr. & different insurance but similar problem.... I am seeing Dr. Jawad in Ocala, FL and Nicia is who handles inusrance packets, authorizations etc. I turned in all of my paperwork and sat waiting for a week wondering what was up...so I started following up only to find that they hadn't sent it for the same reason as you Marcie (I had six months but it wasn't consecutive). Nicia did not feel that I would get approval with the lack of 6 consecutive months. After appealing to her she finally decided to send it the way it was and take the chance and deal with an appeal later. Needless to say, I was approved within 24 hours...the reason? While most insurance companies have a bad wrap about strict protocol, in all honesty, and IF they are not back-logged in medical review, they look at and consider your ENTIRE packet...the focus is not necessarily on one particular requirement when you've met all the others. Another kicker, Dr. Jawad's staff was in a bind at the time too. One girl who assisted Nicia had just quit and the new girl had just started training. Nicia just happened to be a VERY caring dedicated individual as I am sure Susan is. If I could make a recommendation to you...sometimes you just have to keep on people-FOLLOW UP. Your the patient, this is your health and you have to take an active role too. Bug the crap out of these people, BUT BE CURTEOUS ABOUT THE WAY YOU APPROACH (they really are trying to help you), Susan, the PCP, the insurance-sad but true, eventually they will give in. My suggestion, keep the appt with your PCP and see what you can pull off. If nothing changes, urge Susan to send it anyway b/c whether you are approved or denied is ultimately not her decision. Good luck to you! Danielle

THanks Danielle! I have absolutely no doubt that Susan probably has a lot on her plate. It's a busy office and Dr. Murr is a popular surgeon due to his great reputation. She has been wonderful so far and my first impression of her was definitely good. I have absolutely no hard feelings towards her. I was just shocked yesterday and more frustrated than anything. I am going to my PCP tomorrow no matter what and talk to him about everything and see what he has to say.

I have to agree with Lori. Dr. Murr and Susan are professionals and are doing their best to handle everyone's individual issues. Each of us has a story to tell about how their approval process was handled. However, bottom line is that it is the patients responsibility to research if the surgery is a covered procedure and EXACTLY what documentation is needed for the approval. It is not Susan's job to do that. It is important for us to remember we are pioneers in this world of bariatric surgery. There is so much misinformation floating around out there. Additionally, i am not sure how many of you realize that there is a HUGE population (no pun intended) of patients who go through this surgery and NEVER show up for their follow up visits. They simply wanted the surgery and are not interested in anything else. This is a disservice to the surgeons practice who then can't complile appropriate follow up statistics. I am concerned that the blame is always on someone else rather than ourselves. It also concerns me that many people have no diet history to submit. Come on people, this surgery is for those who have had a lifelong weight struggle and significant documentation of diets. I am worried it is becoming a "fad". I take this seriously. THe surgery has changed my life. I did the research, the homework, spent my share of the co payment without whinning, blaming or *****ing. I wouldnt change a thing about my experience with Dr. Murr or Susan. What doesnt kill us makes us stronger.