United Health Care

Hi All, Has anybody else had any problems with United and trying to get the surgery approved?  Dr. V office just called and said United wont cover my surgery.  I am so sad right now.  I know they are hard to deal with but this is crazy.  Any words of advice would be greatly appreciated.

I am pre-op with Dr Roye and I would get a detailed reason as to why ityou were was denied. I have Blue Chip and there is a rider on my policy from my husbands work that EXCLUDES ANY Bariatric surguries ans I was approved for both lapband and rny 1 st try. I think it has a lot to do with the wording on the submission. Call United and see why it was denied start a appeal, ask the dr office how it was submitted and what was stated.  jaime

I do not have United, I have Aetna, and they gave me a "Policy Bulletin" number which I could look up online on their website.  It listed everything they require before they will approve me.  I had some questions about some of the items on the PB, and after not getting anywhere with customer service,  I spoke with someone in Pre-Approval who could answer my questions.  Try to get something in writing if at all possible.  And don't settle for the CSR's to answer your questions. They don't know much about the specifics, or they won't answer you if they do.

Hi, I have to say, if there's anyone who knows about disappointment because of the insurance merry-go-round, it's Cara! She's been through helm and back! I hope things work out for you. You have some great advice here. And make sure you write down EACH and EVERY person's name you speak to. Get their extension number, write down the date and time. Eventually, you'll hook up with the person who knows the real culprit for the disapproval. Good Luck! And break their legs....Ooops....I mean break A leg!  Jules

You need to learn your policy backwards and forwards, that's the first thing.  I did that before I started the process just to avoid any potential disappointments.   I have UHC & they were an absolute dream to deal with- but I gave them everything they wanted me to, and nothing more.  I had to document 5 years of obesity and they approved me within a week of my pre-op visit.  The first step is to find out what they cover, because if WLS is a written exclusion it won't do any good to appeal it.