Problems with UHC..

I don't know what is going on but I was denied in Jan for WLS. There are only 3 req's and 2 of which they couldn't denied me on. 1. must be greater then 100 lbs..got that 2. has been so for at least 3 years, despite documented unsuccessful attempts to reduce under  a physician monitored diet and exercise program. 3. must be 25 or older. So they denied me on the 3 year thing even though they have my medical records for the last 6 years.  So I got my dr to write a letter saying I have been a patient since 2001  and we discussed my weight issues and a variety of ways she could lose weight any questions to call I got my records from jenny craig and med recs back to 99 I also included a letter of my attempts and addresses and phone numbers to places I have worked out. I really don't know what else to give them. So we mailed it on 27th. Faxed it on the 28 and then on Monday they said they never got anything and so we re faxed it again on the 5th. So today I called and they never got it. So they gave us a different number to fax it to.. I'm so tired and frustrated. I don't know what they want or what to do. I'm feeling very defeated. I read lots of the posts here but don't have a lot to offer. I just wanted to say I understand how your all feeling and we just can't give up. Its not over till we say it is LOL. GL everyone. I hope you have a great weekend Rebecca

Hi. I just wanted to tell you that my sis in law has UHC & though she didn't have to deal with the whole denial thing she did have major issues with them saying they didn't get her info when they really did have it, but because it hadn't made it to the right "department" they weren't showing it as being there yet. Make sense? She had our surgeon's office refax it and after almost 2 weeks they finally showed that it made it to the right place. Overall it took a little over a month between the initial faxing of the info until she found out she was approved. I have heard of other UHC people having the same exact problem. Hopefully knowing that will help ease your nerves a little.  Good luck! Jenifer

I also had problems with UHC. For almost 3 months I waited and called and re-faxed. Then on 1/31/07-The Denial. I was furious, all the reasons they used for denial were wrong--if they had looked at the records sent to them. I asked for an appeal. In the meantime I looked into changing insurers. To make a long story short, I changed to a BCBS product and was approved in 2 days! Low and behold---3 weeks later I receive a letter from UHC: case reviewed, original desicion overturned, you are approved!!
Keep you chin up and fax, fax, fax!!!

Patty

Thank you both for replying. I thought about calling today and checking if they got my fax but really I'm tired. I just didn't want to go another day frustrated because they can't get it together. I might call tomorrow. Its nice to know there is hope out there. I feel like I need to set myself up for a deniel but then thats not thinking positivly so I am praying and hoping that all goes well.  The most frustrating thing is that we are paying a TON of money for this insurance just  because of the coverage 90/10 of WLS. Thanks again Rebecca