n00bie questions and help re: UHC and WLS

Hey all,
I just started my research into my WLS.  I am insured with UHC (UHC Options PPO) and called the resource center to open a case.  They told me that a insurance coordinator (or sth like that) will call in the next 3 business days to discuss it with me.

I have not talked to a doctor/surgeon yet (there is terminology in the UHC coverage docs that indicate I need to talk to UHC first)

Anyone with UHC have any idea what I can expect?

(I am reading through this forum, so the answer might be down there somewhere) -- Thanks in advance.

joshua

Basically, the coordinator will guide you through the process.  They will ask you some questions about you and your health.  This will help determine if you will meet their qualifications for surgery.  The coordinator will then explain what your requirements will be, different UHC plans have different requirements.  Most plans require a physiological assessment, 6 months of support groups, and  a 3 or 6 month PCP supervised diet.

Thanks sportsbaby!

For anyone playing along at home, or curious as to the answer to my questions above...

I didn't get a call back from UHC in the 3 business days they promised, so I called and left a message with my Nurse (who had been assigned) and she called me back the next day (today).

She explained the types of surgery that my insurance will cover (bypass and band).

She explained the selection criteria for locations where I can have this done (asbs.org certified + certified by UHC).

She gave me a list of Hospitals (2) /Doctors (5)  in the area that I could talk to.  She encouraged me to call and schedule to attend a seminar and schedule a surgical consult.

I don't need to be referred to the clinic, I can call the clinic directly.  All pre-op requirements are to be set by the surgeon.  Once the surgeon and I am both satisfied that surgery is the best option for me, the doctor's office will schedule surgery and check with UHC for approval.  She said that there is no requirement from the UHC side for x-years of history or y-months of supervised diet -- that's all up to the doctor.

Hi Joshua,

I have UHC and it is just a slow process.  I have been trying to get my approval since july 2nd.

I have gone thru the classes and psych eval the DR requires...thank goodness UHC paid for all of that. 

The Dr. requires pre-determination from UHC...I guess they want to know exactly what UHC will pay..that is where i am stuck. 

Hopefully yours will go quicker.

good luck.
susan