UHC Extremely "NOT" Helpful

I have called UHC repeatedly asking for assistance in locating a bariatric surgeon in network in baton rouge...i have received zero assistance.

I am so frustrated at this point that I am ready to cancel my policy and abandon this whole endeavor.

Has anyone else experienced this and if so, what did you do?

Just venting...thanks.

Sherry,
I called UHC first and told them I was interested in Bariatric surgery.  They asked me a few questions and forwarded my info to a case nurse.  The nurse assigned to my case returned my call, asked me a few more questions, told me what I needed to do to get my surgery approved, once I submitted the required documents to her, she called me and told me I was approved and what doctors I could use.  Maybe you can try that route..The case nurse is the one you will deal with through UHC.  They will call you after surgery to check your progress every month also.

I will try that...so far I have only gone through customer service and they are unable to assist.  Thanks!

After multiple phone call, transfers and disconnects, I finally got a very helpful person on the phone.  Rachel stayed on the phone with me for over an hour and I am cautiously optimistic that I may be able to use a surgeon in Baton Rouge.

Keep your fingers crossed for me that this pans out...I have butterflies just thinking this may be possible after waiting so many years to find an insurance policy to cover the surgery for me.

Thanks for all the feedback & ts for the tip on who to talk to at UHC...let's hope this works!

I sent up a prayer for you and crossed my fingers (lol).  It's going to work out for you.

Tarsha (ts)

The practice I deal with is in network for UHC, but my UHC policy (Office of State Benefits) has an exclusion. I had surgery a while back with another company.

If you are still looking, send me a PM and I'll make a call for you. Let me know which UHC you have and I'll check with the office. I do contract work for this practice, so I'm in and out of the office quite a bit.

I do wish you well...never give up, please!
Frances

Thanks Frances...that would be very helpful!  I will send you a message.  Thanks!

I've had COUNTLESS problems dealing with UHC. Very long story and I'll spare you the details, but the basic jist of my situation is that with my company, they have a third party dictate Bariatric procedures. You have to call a separate number to find out exactly what you need to do. That number is at the bottom of the page that they're looking at when you call them.

Now I got lucky and my doctor is with Oschner so they just referred me to Oschner New Orleans and I'm going there. If you find a UHC doctor in Baton Rouge please let me know. I like everyone in New Orleans, but I don't know too many people down here so I'm terrified that I won't have anyone to take me home from the hospital after I finally have the surgery.

I certainly will...good luck!

Hi!

I just wanted to let you know that I have UHC (EPO).  I am using Dr. Haussman in Baton Rouge at the Surgical Center of Baton Rouge and after leaps and bounds, I have finally been approved for Gastric Bypass surgery, which will take place, hopefully, on March 16th.

HERE IS WHAT I DID...

1.  I contacted Josette at Dr. Haussman's office, by telephone, who told me that after attending a weight loss surgery seminar, the first thing they would have to do is submit a "GAP REQUEST", so that I could come in and see one of the doctors there for a consult.  The gap request is a request for coverage of an OUT-OF-NETWORK doctor because there were no doctors that do bariatric surgery within a 50 mile radius.  UHC approved the request for coverage for the office visit.

2. After obtaining the gap request to go in for the consult visit, I decided what I wanted to do and they submitted a request for the surgery type that you want to do.  (UHC states that they do not cover the vertical sleeve.  It is still considered 'EXPERIMENTAL", although, I do have a friend in my office who has the same exact insurance and me and for some reason, she was approved for that surgery on the first request.)  I tried to request the sleeve and was turned down, so I reconsidered and decided that I knew that they paid for the bypass.  My second attempt was a request for coverage on the bypass.  They turned me down after the second request, stating that I must use an "IN NETWORK HOSPITAL AND DOCTOR".   I knew that my hospital was in-network, so I figured it was because the doctor was out-of -network.

Then, I decided to call customer support for UHC and request the name of a BARIATRIC doctor in the Baton Rouge area, because their reason for not covering my surgery was because I needed an IN-NETWORK doctor, and the CS Rep could not give me the name of anyone and forwarded me to the "Network of Excellence" people who proceeded to tell me that the only doctors that were in network were in New Orleans at Oschners.  She tried to tell me that I would have to do a 6 month diet and excercise program supervised by physician and that I would have to have a psychiatric evaluation.  (Already had the psych eval.)  Then I told her that I was appealling a decision and requested that she close my case.  BE VERY CAREFUL IF YOU DECIDE TO CONTACT THESE PEOPLE.  You do not want to have to adhere to anything extra if you don't have to.  (I did not do a 6 month diet and exercise program through a physcian)  Anyway....

HERE IS THE CATCH...

They approved the gap coverage for me to have a consult for Dr. Haussman, so the WONDERFUL , Amy Beck, Surgery Coordinator, submitted an appeal based on the fact that they approved the gap request for me to see him in the first place.  Why would they approve me to see him for a consult and not expect that I would not consider using him as my surgeon. 

To make a LONG story, shorter...I found out on Tuesday, that my surgery has been approved!

My advice to you is...DON'T GIVE UP.  That is what they want you to do.  They are collecting premiums and don't want to pay out.  That is how they make money.  Contact Amy Beck and Josette at the Surgical Center and talk to them see what they tell you.  225-769-5656

GOOD LUCK....AND REMEMBER....DO NOT GIVE UP!!!!