UHC gave me the big "D" for my VSG

Janet L.
on 3/12/09 12:12 am - Jemez Springs, NM
So I got the big ol' DENIED from UHC for my VSG. I kinda knew that was coming but was hoping it wouldn't happen....  They say there wasn't enough clincal evidence that it works for weight loss....

Now I appeal. Hopefully it works. How long do appeals usually take??
Telisha
on 3/12/09 9:50 am, edited 3/12/09 9:50 am
I am sorry to hear you got denied. I too have UHC and am expecting to have my request denied due to the 5 year history requirement. I was within 35-39.9 range but didn't have any co-morbids diagnosed till 2006 even though I had them dr's weren't looking. /sigh

I don't know how long the appeals process takes yet but i am sure I will find out.

My question to you is.. Is there a way to check on the status online? Or did you just call members services to find out or is there another number to call?

Thanks for the help and again I am sorry.

Janet L.
on 3/15/09 4:13 am - Jemez Springs, NM
I called UHC everyday till they gave me an answer. I'm not to sure how long it'll take for the appeal. I've heard 30 days to 3 months... I guess i just have to wait and see. I meet all the requirements for and RNY or lap but I'm wanting the VSG. I really really hate the insurance game we have to play to get approved. 
dyamondchic
on 3/15/09 3:22 pm - alexandria, VA
Dam that sucks! I have UHC I live in VA and work in VA but am going through Dr. Afram in DC @ GW Hospital for my surgery. The nurse for his office called me and said my insurance just needed a five yr weight history! I freaked out thinkin it needed to be documented but she said no they just needed the numbers from 5yrs! I was so excited and thankful!!! So she told me they needed to do a little bit more paper work but for me to make my pulmonary and sleep apnea doctor's appts ASAP so I'm thinking the nurse thinks i will get approved within the next week! Hopefully!! When I first went to the consultation and told her my insurance co. she said "O UHC is pretty good" So i think it depepnds on the area ur in as well!  I think it depends on your companies policies on WLS as well check your benefits plan for your job and read it word for word maybe you can find some exception to the rule! Keep fighting tho!!!
Sabrenia8888
on 3/24/09 9:22 am - Orlando, FL
Hey can you assist me with the 5 years history for UHC. I just want to make sure I am sure on what needs to be submitted. So I just need like records that show my weight correct. So if I went to planet fitness and they weighed me, I can submitt correct?
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