New Raleigh, NC

I haven't written any new post yet - I'll hold off til Tuesday - basically, little miss insurance girl at the office told me back in March that she had talked with UHC about my surgery, and my plan would cover me at 70% after I paid a $1,000 deductible, and with me paying off the 30% afterward.  Don't know where she got that number she gave me, but insurance is saying that they told her back in march that my plan did NOT include WLS.  so I've been jumping through hoops for over two months, the office has been scheduling all my pre-op stuff, and I've done everything, including having an endoscopy yesterday, and now my insurance company is saying I"m not covered. 

I'm hot under the collar, to say the least, so I'm holding the surgeon's office to fixing this issue, since their office staff told me I WAS covered.  I won't know til Tuesday what they intend to do about it, but it had better be good, because I could have dropped this insurance two months ago and gotten a personal BCBS plan  - NOW though, if I did that, BCBS would say "pre-existing" since I have jumped all the hoops and I'd probably have to wait a year.

I'm very frustrated.  If this ISN'T dealt with, I will never recommend United Healthcare to anyone at all EVER in NC.  And I won't be too highly recommending Dr. Enoch's office staff either, unless they help rectify this situation.  We'll see *sigh* - I was so excited, having done everything. :(

Now I'm just frustrated and sad.

I AM, however, still very happy for you :)

That is nuts.  I have to say the insurance girl I have been talking to has been irritating me when she said I possibally wasn't covered.  I talked with Angela the first time but I have never been able to talk with her again.  The girl named Lisa doesn't seem to have it together.  That really sucks about UHC. I have heard they are PITAs.  Did you try the appeal. I am sure some people have use UHC to get WLS.  I also heard some insurances always deny people the first time.  Go through the appeal process.  It may work.  Maybe Enochs will give you a discount or a great payment plan. I can't imagine how frustrated you are.. they are the insurance experts and they should look at plans carefully.   I am lucky that BCBS puts their policies on the web. I had already read them and they are pretty much cut and dry with what they will cover.  I hope I don't have to have an endoscopy.. I go next week for my GI consult.  


I hope you get some good news on Tuesday.  Try to have a great holiday weekend.  Sorry.
Kelly

Hi Kelly - I've had to deal almost completely with Angelica at the office, and it has been frustrating.  Lisa is the nurse practitioner/assistant to Dr. Enoch, so she doesn't know a lot about the insurance end, I'm betting.  I hear she's great for follow-up after surgery though.  Most people rave about her follow-up care, as she is the person they see the most after surgery.

I just hope they make it right.  I know Dr. Enochs is a good surgeon, and I really want my surgery with him - Perhaps since I have to get my gallbladder out (the gastroenterologist highly recommended it after the upper GI showed a lot of stones, and I've passed two, which isn't a piece of cake), that will make a difference.  Dr. Enochs can still do the gallbladder surgery, and insurance will pay for that - so maybe we can work out a plan for adding WLS to the gallbladder surgery.  I hope so - I'd hate for his office staff to be detrimental to his reputation.

Anyway, I'm just going to try to enjoy the weekend, gather appeal documents for insurance, and hope that their office makes it right.

Have a great memorial day weekend!

That definitly sounds like a good plan.  I hope you get good news on Tuesday.

Have a good weekend...

Kelly