A piece of information ( I wish I would have had a year ago)

Nicki104
on 5/13/10 9:54 am - Portage, WI

I have been battling with UHC to get the lap-band.  They denied me (without a reason) Jan. 2nd and when I appealed - they denied me because they said my selected surgeon was convered (However, this is untrue - he is covered until June 30th).  I Sent my second appeal about this and didn't get a response.  After waiting for 6 weeks, I phoned them and spoke with a customer service rep. she stated she would look into it and call me back the next day.  Another week passed and I called UHC again.  After speaking with another customer service rep. I got the feeling that I was STILL getting the run around SO, I asked to speak to her supervisor.  This is the important part ---- SHE has busted her butt to get REAL answers for me for the passed 2 weeks!  I wish when these problems started I would have had this woman in my corner.  I now have her direct-line number and she has pushed and pushed to get REAL answers for me.
I suggest to EVERYONE that from here on out -- if you call your insurance company and the rep. doesn't seem to be of assistance IMMEDIATELY ask for the supervisor.
So, the good news is that my surgery is finally approved with this surgeon, thanks to the hard work of this woman.  The bad news is that services with this surgeon will expire as of June 30th so I wouldn't be able to have followup care with him
Good news - I have already begun the process with a new "covered" surgeon at a different clinic and allegedly, everything will float right through with UHC.  And if they don't I have the direct number of the woman that can "make things happen". 
The moral of the story is DO NOT walk away just because you got a denial letter.  FIGHT for yourself --- be your own advocate!

        
Believe in YOU!            
ScottAD
on 5/15/10 9:53 am - Lenoir, NC
RNY on 07/31/12
Thank you for posting this Nicki.

Really, I mean it. I think that the encouragement is necessary because if you just take it lying down then you're giving up.

I've worked in customer service for years and I agree with sometimes having to ask for a supervisor. The representatives can only do so much and they cannot refuse you that request.

A similar thing happened to me regarding a notebook I purchased and I have to say the supervisor worked their butt off to get things done and follow up. It certainly made my experience much better than how it began.

Don't give up, keep moving forward.
Most Active
×