Question:
Has anyone else had the experience that UHC changed its policy about pre-determinatio

I contacted UHC today and they said that they no longer do pre-determination. The surgery is covered so when I asked they said to treat it as an approval, but they will review the medical notes after surgery to see what they will pay and what they won't. My surgeon's office did put me on the waiting list, but since the surgery is $35,000.00 I'm a little worried about getting stuck w/ the bill. Has anyone else had this experience.    — laura J. (posted on April 22, 2003)

April 22, 2003
When did this policy change? I had surgery feb. 10th and had to get pre-approval. It took two weeks for them to approve after they received my paperwork. They sent both the doc and myself a letter of approval. I have UHC select.
   — Delores S.

April 22, 2003
I have United Healthcare EPO - California. My paperwork was submitted on March 14, 2003. I was approved on March 28, 2003. You may want to call and talk to someone else just to make sure you get the answer or ask them to send you a letter stating that they no longer do pre-determination.
   — gunter73

April 22, 2003
I would definitely call again and get it in writing. I just talked to them 2 days ago and they said they it was covered but it had to have pre-certification/Pre-determination.
   — Kim M.

April 22, 2003
I also have UHC EPO, I have had them since late last year. I haven't ever had to get anything pre-approved by them, but the surgeons are getting the surgery pre-approved anyways. I think that is the safest bet anyways! Good Luck!
   — Saxbyd

April 22, 2003
This policy changed a few years ago. Basically all they did was left the medically necessary decision up to the doctors. IF the surgery is covered by your plan, you do not necessarily need pre-approval, as the surgeon has already stated that it is medically necessary. The people that get denials from UHC are because it is not covered by their plan. At the time I had surgery I worked for UHC, I sent off for my approval anyway....just to be sure. :)
   — RebeccaP

April 23, 2003
I have been told the same thing. However my surgeon will not do the surgery until they have something in writing! I have been waitng since March 18th, and have had to cancel two surgery dates! I have been told by UHC that they will send something in writing to me and to my surgeon. Good Luck!
   — stacy W.