Anyone have Uniform Medical Plan?

Hi,  I'm new to the site.  It was recommended by the surgeon's office nutritionist that I check it out.  I've just been hovering for a few days checking out the posts so far. Question...anyone here have the Uniform Medical Plan?  I'm almost to the point where they will submit everything to the insur for final approval and then my surgery date can be scheduled.  I was just wondering if anyone has already been through this process with Uniform and what your experience was. Thanks Alicia

Hi Alicia.  I have uniform medical.  Are you a PEBB employee?  Have you been accepted into Uniform's program and "case managed"?  If you've jumped through all those hoops and done all the hoops with Legacy, it should be no problem.  The case manager just gets the final go ahead from the powers that be.  They authorize surgery for a period of 6 months and you are supposed to have it in that time frame.  If something happens beyond your control (like me....my liver was too big when Emma got in there) they will extend it as long as you are complying with the surgeon's suggestions.  Hope that helps.

tk

Yep, I'm a PEBB employee, I work for UW Medical Center.  I've done everything so far and am trying to get the office next to the surgeon's office to transfer my paperwork over so I can sched the surgical consult but they are dragging their feet. When Dr Patterson's office submitted everything for approval how did it take Uniform to respond?  My case manager said it takes between 1-5 business days.  How quickly were you able to schedule your sugery with Dr. Patterson after approval?  Did you have to submit your food/exercise logs? Thanks for responding, I really appreciate the info.  I'm very anxious to get scheduled so I can start planning the next steps. Alicia

Do you have Riaz for your case manager?  I started back in 07, so things may have changed slightly since then.  Approval happened fairly quickly.  Surgery date is kind of dependent on the time of year....Christmas time is pretty busy.  Emma says normally about 2 to 3 weeks.  If you've turned in all your excercise logs to Riaz, you don't have to do the same for Emma.  Have you done all the psych, nut, blood work up tests? tk

Yep, he's my case manager, I did the medical, psych, pt, and nut consults on May 13-14 and they said that each of them signed off on me. They told me today they're still entering everything in the comp and that the surgeon's office should have my file by Friday at the latest. Riaz didn't require me to send him my food and exercise logs.  I only had to send him my weight every 2 weeks until I met the 5%.  That was March 19.  Since then I've talked to him a couple times with questions but that's it.  My aunt is also going through the process and has Riaz as a case mgr as well but she has been required to submit her logs since starting the process (and she started just after I did in Jan 08).  I don't know why she has to submit them but I didn't. I'm hoping for a July or earlier date....you think that's realistic?  When are you resheduled for? Alicia

I'd say probably by August.  Once you get in to see the surgeon it goes pretty fast.  Interesting that Riaz is making your Aunt submit stuff and you didn't have too.  Riaz was kind of passive agressive with me until I lost my weight...then he was all nice and supportive. I've been a freak case.  I went in for surgery in December.  Emma had to stop because my liver was too big.  So I've been working on losing more weight to shrink the liver.  Been a long, hard process.  50 pounds down and liver is still too big.  Yuck.

tk

Yeah, I know what you mean with Riaz.  He's a bit moody at times.  I once left a msg on option 6 instead of option 4 when I called (after my phone consult) and when I didn't hear back for a few days I called back and he answered.  Then he said he had just received the msg and that I was supposed to press option 4 instead and then he wouldn't gotten the msg sooner.  Then he started complaining that people dont listen or pay attention.  I mean, give me a break!  I hadn't called him for 3 months and I don't exactly carry around all the notes I took when we had the phone consult! I'm sorry to hear it's been a problem but that's great that you've lost 50 lbs!  And August is right around the corner! With my aunt, maybe they have slightly different requirements depending on age and/or comorbidities.  I'm 27 whereas my aunt is 53 and has type 2 diabetes, hypertension, high chol, and sleep apnea.  I have slightly high chol (211 in Jan, 196 2 weeks ago) and moderate sleep apnea.  I started at 19 pounds heavier and I'm 3 inches shorter than her.   I'm trying to motivate her to lose her 5% but nothing seems to be working and it doesn't help that I live 2.5 hrs away).  She started water walking but says she can't lose 15 pounds.  I think maybe once she sees me go through it maybe that will help motivate her. Alicia

I don't know if the rules are the same but you may want to tell your aunt that she only has 6 months to lose her 5% (from the time she was accepted into the program).  I didn't find that out until 5 weeks before my time was due.  Riaz told me that you get kicked off if you don't make it...at the time I was in the middle of everything there were no extensions.  He's also not very patient if you aren't losing.....

tk

Where does your aunt live?  Does she get on the boards?  I'm in Vancouver.  I've found it to be helpful talking with others.  I've just started.  I think it makes the whole process feel a bit more real and helps me be a little more motivated. tk