Received Denial -- United Healthcare -- Next?

Ok, I usually never post on the forums but need some help/prayers/suggestions --- I once was approved for my Gastric By-pass three years ago.  I was five days away from surgery and found out I was two weeks pregnant in my pre-op blookwork. 

I reapplied with my new carrier, United Healthcare -- Choice Plus -- TN, in January 2010 and they said that all I needed was a 6 month diet.  I just completed that requirement and my paperwork was resubmitted.  I called two days ago and was told everything was fine, it was under review, and that the only requirement left was that 6 months.  Today I called and the very rude lady, Vera, said that I was denied because I did not complete that requirement --- i explained that I did and my doctors office sent in the paperwork (I completed a sheet with every doctors appt with their signature) and she said it didn't matter.  She said I could have my surgeon do a peer to peer with their Medical Director  or go through appeals.

Does anyone have any ideas or stories that can help???

I will be interested to follow your story, I am with the same insurance.  I'm currently completing my 6 month visits and have met with surgeon who doesn't think approval will be a problem, but I am concerned about co-morbidity condition.  I don't have high cholesterol, HBP, diabetes - only asthma, joint paint, shortness of breath.  I am hoping to be approved before the end of 2010.

Hi,

I noticed you are from Plainfield, IN.  I grew up there.  Lived over on Brookside Lane.  I miss Plainfield but I no longer have family there.  Just a few friends.

I have the same insurance and live in Indiana.  I was approved immediately. for RNY.  Not sure if the requirements are the same for the Mini or not.  I have high choesterol and some back issues occasionally.  I think my Dr. office knew just what to send/say. I had the 5 years of documented weights.  I thought I needed the  6 month diet thing too, but I didn't.  Possibly because of my back.  My Dr was Rose Marie Jones at Carmel Surgical Center in Indy.
 (I highly reccommend her) .  You might see if they have some advice for you.   Let me know if you have questions I can answer for you.

Here is a YouTube video on insurance and the MGB.

http://www.youtube.com/watch?v=-0mZ4xTjCdc&feature=youtu.be&a

I did not have problem when they filed for my lap-band. I think you need to have them to resubmit your paper work. It is really up to the docotor office to submit the paper work as needed for the insurance company.

Good Luck,
Sabrina