Question:
What is the longest insurance should take to approve WLS?

Hi, I am hoping to have Duodenal Switch. I have United Healthcare HMO. I had my consult with my surgeon on Jan 15th and my insurance company received all my paperwork on Jan 20th. I am STILL waiting to hear from them. They told me it could take up to 6 weeks, but usually is processed alot sooner than that. On March 2nd it will be 6 weeks since they recieved the paperwork but every time I call (and I call them every day) they say it's "still in review". They tell me it is where it needs to be, as in right department, and they say that they have all that they need, they are not waiting for more documentation from my surgeon or anything. So what is taking them so long?? I have heard so many people say that UHC is usually really quick and no-hassles. But six weeks doesn't seem very quick and it's really becoming a hassle to me to have to call every day just to be told "it's still in review". And their Care-Coordination people don't seem very helpful. They can't give me any idea how much longer it's going to take or even why it's taking so long to begin with.. Does anyone have any ideas? Or is this normal?    — Mike F. (posted on March 1, 2004)

February 29, 2004
I dont haveyour insurance; BUT I would check your employee medical handbook - there should be a 'time' frame in there. Such as when I got my approved the insurance company only had '30' days... see what your 'time' frame states; if it says 6 weeks; then so be it; but it should be documented some where how long they have.
   — star .

March 1, 2004
Mine took 15 months
   — Robert L.

March 9, 2004
I have UHC PPO and it too exactly 10 business days to get approval. Case started on Feb. 16th and approved on Feb. 27th. I called everyday, I already knew my surgery date and I told the care coordinator and she added that note to my case. It probably didn't speed things up but with UHC, if you do not start a case in the care coordination unit, your info will get lost and float around UHC with no specific place to go.You want to make sure your info goes to the care coordination unit to be reviewed by a nurse. Otherwise, your approval could take months. Get with the insurance rep in your surgeon's office. Stay on top of UHC!
   — Shayla527

March 11, 2004
I have Aetna and I saw surgeon in Sept 03 and had to appeal twice. By the time I was approved, it was 1/18/04. So this could take a while. I know it's hard playing the waiting game, (this was torture - so close yet so far away) but try to relax and know that soon you'll be on ther losing side. Keep calling 2-3 times a wk, and I do think this will help some. They document all calls, and by you calling often, they will know that you mean business. Good Luck!!! One more thing, from start to finish (getting approved) I fought 2 insurance companies, and it took almopst 3 yrs for me to get approved. For some of us, it just takes longer, but I think I appreciate it more. 352/310/140.
   — bufordslipstick

March 11, 2004
I have Aetna and I saw surgeon in Sept 03 and had to appeal twice. By the time I was approved, it was 1/18/04. So this could take a while. I know it's hard playing the waiting game, (this was torture - so close yet so far away) but try to relax and know that soon you'll be on ther losing side. Keep calling 2-3 times a wk, and I do think this will help some. They document all calls, and by you calling often, they will know that you mean business. Good Luck!!! One more thing, from start to finish (getting approved) I fought 2 insurance companies, and it took almost 3 yrs for me to get approved. For some of us, it just takes longer, but I think I appreciate it more. 352/310/140.
   — bufordslipstick