United Health Care Approval

Hi everyone!
I am new to this board, but I am 3 1/2 years out from a DS. I was recently denied by my insurance company for Abdominoplasty/Panniculectomey/Ventral Hearnia repair surgey, but lucky me...my company switched health care providers at the 1st of the year. 

The new provider is United Health Care..
1st question - has any one had success with approval with UHC? and if so, what were their requirements.

In jumping through hoops with the last company, I had to obtain 6 months worth of documentation from a dermatologist showing that skin issues were still an issue after treatments.   In total, I have 5 drs recommending the surgery: Dermatologist, Plastic Surgeon, DS Surgeon, Primary Care Physician and my OB/GYN.  All of whom has seen and documented ongoing skin issues (some including photos).

I just spoke w/ my benefit administrator in regards to trying to specifically find out what is needed for approval - but I wanted to post here as well.  Hopefully, I don't have another 6+ months of hoops to jump through; if that is the case I will probably just go ahead and get the hernia repair done and be done with it.

Thanks for all of your responses!

~Cindy


 

It may depend on your policy your company has w/ UHC to see what exclusions they have. My company switched to UHC last year (6 months after I had my panni covered). My companies policy does exclude any abdominalplasty or panni removal as one of their exclusions. I would take the time to read the policy and all the exclusions. Even though people have the same carrier it depends on each company policy choice to see what is included or excluded w/ each policy provided.