United Healthcare Exclusion

Haleyzcomet
on 7/5/07 11:27 am - Farmingville, NY
Hi! I have United Healthcare and before I started this long process my surgeon called United Healthcare to check benefits and was told that surgery would be covered and told them specifically what I needed! After weeks of all my pre op testing and time and money spent I received a call today telling me they had received my claim but that I had an exclusion in my policy for WLS.  You can imagine how angry I was after that call. The only choice I was given was to file an appeal. Any thoughts Gary on where I can go from here? Any advice would be greatly appreciated.
.::Princess
Nutmeg::.

on 7/6/07 9:43 am - Rohnert Park, CA
A) did the surgeon make a note in your file that it was covered? B) start your appeal. C) If all else fails, I know some people who know some people... (jk)
(Hi/DoS/CW/GW) 335/320/243.5/174  (-91.5)(total lost) in 18-20 dependent on brand!
I'm more than half-way there! :) (68.5 pounds to go)
butterflyness
on 7/7/07 2:48 pm - KS
The EXACT same thing happened to me.  Seriously.  I went in to talk with the wls company and they contacted my insurance and they were told that "yes it's covered...here's what you need to submit to us"  so after getting all my medical records, getting a pysch eval, spending hours and hours researching and taking time off from work to get everything done, it was all submitted in february.  I was then called by the wls center and was told that there's an exclusion from my employer.  Being beyond pissed is what i am.  I went all day without crying at work and got home and broke down.  It literaly felt like a knife was stabbed in my back.   so i decied to appeal but the weight loss company i was going through all of a sudden became hard to get ahold of and wouldnt return phone calls or emails.  So i went with another one.  I had all my records and paperwork sent to them.  They said because the exclusion is with my employer they wont submit it.  So i took it upon myself to submit my appeal letters and information.  I recieved a letter stating i would recieve a response by July 22.  I'm sure its gonna be a no but part of me is praying so hard for it to be a yes. I have Unicare insurance btw.
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