United Healthcare... conflicting info on requirements

I have UHC insurance and went for my consult with the surgeon last week. When I called the insurance company (twice), they said the requirements were age 21, inpatient surgery, documented BMI 40 minimum for minimum of past 5 years. Nothing about 6 months supervised weight loss history documented. I told them this when I went to the surgeon consult, and asked the surgeon if it was a requirement of his. It isn't. When I went to check out the insurance coodinator said that, yes, my insurance does require the 6 months supervised weight loss history. Does anybody else have any recent experience with UHC approval? I'd rather not go through the additional time/expense of the 6 months of doctor visits if I really don't need to.

Here is the link to UHC medical policy for Bariatric Surgery

https://www.unitedhealthcareonline.com/b2c/cmaIndexResult.do ?channelId=016228193392b010VgnVCM100000c520720a____&htmlFile Path=/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticF iles/ProviderStaticFilesHtml/MedicalPolicies/Bariatric_Surge ry.htm

Thank you! I'll read it over.

Vicki
I have bcbs of michigan--I am bmi 40 with several comorbities and history of over 5 years of weight struggle with my PCP.  Is there anyway around the 6 month supervised diet and do you know the code for RNY --my insurance company asked me that when I called and asked questions. 

thanks

Usually getting around the 6 month thing is hard hoever, if you have a condition that could potentially put you in a life threatening position waiting to have the surgery some insurance will overide the 6 month thing.   But there has to a lot of documentation to back it up.

As far as the code for RNY will the surgeon be doing a open RNY or Laprascopic

I am interested in RNY Laproscopic-do you know the code?  THANK YOU!  Trying to find out if I can do a 3 month intensive pre-program of supervised diet instead of 6 months.  THANKS again.

The code for RNY Lap is 43644

I was just approved for WLS through UHC, it took less than 3 weeks.  The requirements depend on what type of UHC coverage you have.  For example, I have UHC ChoicePlus.  ChoicePlus does not have a 6 month diet requirement, but other types of UHC coverage do.  Take a close look at your insurance card and it may tell you which UHC coverage you have.  If you dig around on UHC's website you can find the WLS specifics for each type of coverage they offer.  I found the telephone reps at UHC were not too helpful.  I called three times and got three different answers about the requirements for WLS.  Even the first insurance coordinator I talked to at the doctor's office didn't know that the type of UHC coverage I have didn't require the 6 months supervised weight loss.  Fortunately another insurance coordinator in the office was familiar with the differences in UHC plans and was very helpful.  Good luck! 

Thank you very much for this info. I do have UHC ChoicePlus also, so maybe I just need to find the info you referred to on the website and show it to the insurance coordinator at the doctor's office. I did look around on the website a few times and could not find anything. And I tried to get UHC to send me the specifics, but they would not do it. I'll poke around on the website again. Very encouraging news! You made my day... there's hope yet. :)

I am unable to find the information on the website.  Any guidance?