UHC Pre-Determination?

Hi! My pre-determination was sent to UHC today for surgery. My policy is clear on coverage. A few weeks back, the benefits representive explained the coverage: If the BMI is greater than 40, yes it would be covered under the Plan, with no comorbities." I spoke with UHC, and they told me it would take up to THIRTY DAYS to send approval. Is this true?? Has anyone gotten a faster response? Additionally, is pre-determination necessary when surgery is clearly covered? Thanks!

Kelly cant answer any of your questions. but will pray that everything works out for you and soon. God knows what you need and He will take care of it. Welcome to the boards and keep posting and let us know what is happening. Jan

Kelly, I had to do the pre-determination too. my insurance clearly stated that bmi over 40 was covered too. however.. my insurance then said that i need at least 60 days medicaly supervized weightloss trial. (which i had) and a psych evaluation and then some blood work mainly my TSH level (thyroid). so even after finding out i was covered because of my bmi over 40.. there were several othersteps that I was not told about untill after i met with newstart and my surgen.. I have cigna.. hope this helps.. Jai

Kelly, I had a quicker response to mine, but the company I work for didn't have any exclusions in their policy so they didn't send it through the medical review board so I had my approval letter back in just a few days. So really it all depends on your company and how the policy is set up.

They are going to tell you thirty days but keep on their butts and they may deciede sooner. I had uhc when I had my surgery and they lost all my initial paperwork. Besure they dont do that to you. They sometimes like to make you wait to discourage you into not having surgery. A lot of people get approval sooner than thirty days.

Kelly, I have UHC also and my pre-determination is just a formality to make certain that the dr's submittal has all the necessary information. I was told 30 days also and received my ltr in less than 3 weeks but must consider their work load. Good luck w/your surgery.

I had UHC as well. I also had to have a 6 month supervised diet. After completing it everything was turned in I was told 30 days and had approval in 2 weeks. The actual letter came about a week later. Hang in there.