Question:
Approval without Letter

Has anyone out there ever been approved based on just your Dr.'s office calling in for approval, not having to send in a letter?    — Cindy T. (posted on September 15, 2003)

September 15, 2003
My sister had surgery 8 months ago and didn't do anything in the way of submiting letters or other paperwork to her insurance company. Her surgeon, I'm sure, submitted the necessary information on her and she was approved very quickly. Important points - she has SEVERE sleep apnea, hgih blood pressure, and "THE" insurance to have if you're seeking wls - UNITED HEALTHCARE (we live in Oklahoma and she works for American Airlines)- from what I hear from just about everyone - they're great!
   — Carly H.

September 15, 2003
Actually, UHC is my insurance. The reason I asked this question is because my Dr. office said that they called UHC today and they said they may not have to file a letter. I had never heard of this before. Thanks for the post.
   — Cindy T.

September 15, 2003
I have UHC and was approved in two weeks but my surgeon did send in a letter of medical necessity. Perhaps your surgeon gave them all the info they needed on the phone. I have heard of them doing this. Good luck with your approval.
   — Delores S.

September 15, 2003
I have UHC and actually what they do is your surgeon calls in for a pre-approval, if the nurses have any questions regarding you beyond your height, weight, BMI and that type of stuff the nuses will call back your patient care co-ordinator and then they usually say yes or no right then. They called my surgeon back at exactly 3 weeks and said I was approved and needed no further information beyond what they gave them during the initial phone call. Pretty easy really, I did however send them a letter on my own behalf so I am not sure if that helped or not. GOOD LUCK!
   — Saxbyd

September 15, 2003
I have Cigna HMO and I did not have to submit any letter. My PCP did write a letter that was sent along with all my records to the surgeons office (the surgeons office handled all paperwork) but I never had to do anything. ~Sidney~ Open RNY 10-23-02 down 115+ and counting
   — Siddy I.

September 16, 2003
I have UHC, my PCP suggested I have WLS,been wanting it forever, never had Ins. to pay and never had PCP willing to support. I called UHC and was told they would check my status. 6 days later UHC called my PCP for BMI status, then called me to say approved, you will see this surgeon. Then Dr.s office called next day to set up consult. After 3 years trying I believe something just fell into place, and it came about overnight. This was early Aug. Surgery date is 9-30-03, and can't wait! Everything dragged for ever and then just took off. I didn't sign any papers, neither did my PCP, but I was told they didn't have to, my Ins. had all my medical info registered in their system already. Good luck to you...
   — pateblkbrn