Advice please!

Zaytune
on 11/29/07 4:15 am
So I called my insurance co( United Health Care Choice Plus)...and the guy that answered said it didn't appear that I had WLS coverage/ benefit. I then said "well could you please check w/ someone else to make sure?"  He said "hold on", then came back and said he didn't see anything on my plan for it. It's not that I don't want to take " no" for an answer, it's just that I have read about how others have  been told "no" ,only to find out later or w/ another rep, that it was covered! What should I do?
flyrep
on 11/29/07 5:45 am - AZ
Call them back and ask for a mang of  super..... Also call your POE  payroll office, they can tell you or get u to the area that takes care of your insurance . Good Luck!


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BoneyMaroney
on 11/29/07 6:47 am
Definitely call another rep but get the surgery code from your doctor and ask if the code is covered.  All WLS must be medically necessary and there are different codes.  NO plan really spells out wls coverages like they do mammograms or blood tests or apendisitis.  You will get a definitive answer with the proper code for medically necessary wls.

Top weight 244/ surgery 236/goal 137
Zaytune
on 11/29/07 8:22 am
A big thanks to both of you!!  I called a girlfriend in SC who has had WLS, and she said the same ...to call back and speak to a higher up, as well as call to get the biling codes for the WLS procedures! I'll post again when I know more!
JRinAZ
on 11/29/07 11:17 am - Layton, UT
Next time you call your insurance; just give them the ICD 9 code and the CPT code.   They can punch it into their system to see if you have coverage or an exclusion. You can get the codes from your surgeon's office. Good luck!
Joyce 
Rny 2/11/03-> ERny 12/26/07-> Duodenal Switch 5/12/2010   
     www.dsfacts.com , www.dssurgery.com , & www.duodenalswitch.com

                  

Kanetaco
on 1/16/08 2:45 am - Phoenix, AZ

At wliaz.com they use an insurnace specialist that calls your insurance comany on your behalf to determine your benifits.  You just fill out your insurance information release form and within a few days or so you can find out what is covered and what is not.  Calling on your own is like asking the IRS how you can save on your taxes.  

Thanks,

Clay 

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