New here-insurance questions????

jke22
on 5/14/08 12:51 pm - Oshkosh, WI
I went to the informational meeting at Midwest Bariatric in Neenah at Theda Clark. I am in the process of gathering info. for prior authorization. I have Badger Care with United Health Care as my HMO. MBS is telling me I need to see a dietician for 6 mos. before they will submit the prior auth. United Health Care will not tell me if this is necessary or not, but they did tell me seeing a dietician is not covered? How can they require it for prior authorization, but not cover it?? Does anyone have any information or experience with this? Thanks for your help.
cc.76
on 5/14/08 9:33 pm - WI
I had neither your insurance or your surgeon...but I can tell you that my insurance required a LOT of stuff...but covered none of it.  Dietitian, psych, blood work, 3 months worth of Dr. visits...etc etc etc.  They covered the surgery....but none of the pre-ops that THEY required.  It was complete bull**** and I spent well over $1000 dollars before I even had surgery...and don't even get me started on the crap they spanked me with AFTER surgery. They can require it and not pay for it...sad to say.
Denise32
on 5/15/08 8:01 am - Appleton, WI
I had your insurance and your surgeon.  The dietician can be substituted for your regular pcp. But you have to go religiously. You canNOT miss one month. For example if you saw the doctor on April 30, and the next time they get you in is June 1... whoops.. you missed May! Start all over!  So be sure to hit every single month.  I was denied and appealed.... your insurance can be a stickler. Don't let them discourage you.  Feel free to PM me with any questions.  Like CC says.. you will go through a lot of bull**** but you gotta do what you gotta do.. they have us by the gonads!

Denise        ~Do not judge me. I know I'm not perfect nor do I live to be. But before you start pointing fingers make sure your hands are clean~

cc.76
on 5/15/08 9:32 pm - WI
And can I just add...I love the word gonads?
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