What do you think?????????

My information was sent to UHC 2 weeks ago.  I have been calling daily.  Yesterday my pre determination was in review.  Today I am told the nurse reviewing it has sent it on to the final step and she did not request any additional information.  The care coordination person said I should know in 5 days the outcome.  If no additional info is requested is that a good sign for me????  I did not have the 5 yrs of doctors notes they asked for.  Only been going to doctor for 3 years (since acquiring insurance).  I have bmi over 35 and I have diabetes type 2  Heart disease (stent placement this year) I also have high cholesterol and gerd.  Should I just keep holding my breath or maybe breathe a sigh of relief??  I dont know what to think after this conversation with CAre coordination.  Anyone with opinions out there?  Oh and my gall bladder needs to come out as well.  Gall stones.  I just turned 40 and feel like I'm falling apart :(

I understand the falling apart part.  I will turn 40 in December and I feel the last year I have gone downhill.  I feel like I am 60.  I have no idea what to make of the review process.  I kinda thinks it means you might be approved.  If the nurse was done and denied it then they should of told you that I would think.  But I am no insurance expert....  Heck my papers finally made it to insurance earlier this week.  So I am sitting here on pins and needles myself.  They told me I would have an answer in 15 days.  Best of luck to you....Keep us posted.. ((HUGS))

Thanks for your reply!!  The waiting is so dang hard!  I give myself a headache daily over all this.  I'm not sure what to make of it all myself so I just keep waiting I guess :)  I hope you dont have to wait very long and you get a positive answer SOON!  I am hoping to have surgery the week between Christmas and New Years.  I've already paid in my out of pocket for the year and really dont want to have to come up with 1,000.00 to have it in 2007.  Please keep me posted on how things are going with you!! GOOD LUCK!!!!   :)

Paul.... It's refreshing to see someone take the time, as I've seen you often do, and approach this in a rational fashion.  I've considered myself pretty balanced and level headed with things but I have to admit, this process can drive you crazy.   One thing I have learned from my denial is that you have to be in control of the whole process, not allow the surgeon, PCP, etc. to do the work, but help them gather everything that is needed.  This is done by knowing what is expected by the insurance company for approval.  Boy, I learned that lesson the hard way.  I have everything required this time around, plus additional items not required but I feel is strong for me to achieve and be successful.   My fear of the unknown is the fact that my own HR Dept tells me that this surgery is RARELY approved and to know that up front.  That my insurance is funded and the company I work for sets the guidelines.  So it just leaves me with a bad taste in my mouth that I can meet all the requirements and still be denied the surgery.  I'm thinking that I'll have to hire Gary and will know soon enough as my paperwork was finally submitted on Wed.  I don't like to be a haunt, so I will only call the insurance company after 2 weeks have passed.  That will give time for processing and reviewing.  Last time it took 2 days for my denial.  So no news can be good news. Thank you for your comments.  I just wanted to let you know I do appreciate reading your posts.

Thank you Paul.  There is no exclusion as that was the first thing I asked prior to starting this whole process.  They faxed me a copy of the guidelines I needed and that is what I have followed to a T. Your profile is amazing and you have put much thought into helping others regarding this process.  Again, I thank you for helping and encouraging.  It's refreshing.

Paul I really appreciate you taking the time to reply to my post.  I guess I had read tons of comments about calling the insurance company daily.....Let them know you are on top of it...etc...  Anyway I guess my calling did not bother them because, Yes, I did call again today but............They told me a letter of approval had been sent out today to my surgeon and myself.  I am so excited I can't hardly stand it!!!!!!!!!!!  You sound so knowledgeable about the entire process and I do appreciate all you wrote to me!!