UHC denial

I was verbally approved in mid October for WLS, and then 2 weeks later, my husband's policy was renewed with an exclusion. Our insurance broker appealed this for me since I had the verbal OK, but had to go in network, but she was unsuccessful. I am not willing to accept this, and would like to appeal on my own. Can anyone tell me if I would need to go to r. Jawad, get the denial, and then appeal from there? What steps do I need to take to do an appeal. I have a BMI of 50, and multiple comorbidities. Does Dr. Jawad require the psych eval? I've heard UHC will not pay for that.

im sorry to hear this... im not sure what you need to do... but good luck

Hi Debi... I'm sorry about all the hoops you've had to jump through only to get denied in the end. There is a lawyer who works specifically to appeal cases like this. Unfortunately, I don't remember his name or addy! If you post a message on the Main Message Board, you will probably get his name. Anyway, if you should need to write any appeal letters, check out mygastricbypass.com/appeals.htm for some great example letters. Good luck to you in your pursuit toward WLS!! Blessings, Kelley

Dr. jawad does require a psych eval and you are right a lot of insurance companies do not cover it. I know that they have a psych person they will refer you to. I have heard that it runs about 250.00. Wishing you success through this very frusterating process. Kirsten

debi, i have uhc (i plan) its like a ppo. i had wls on april 4 and i was approved like in the begiining of march. i too needed to do a psych eval and they covered 2 visists. so it might be the type of pln your in. as far as appealing i dont know anything on that but i do no to tel you not to give up and keep on trying... goodluck jennifer