Question:
Where to now?

My doctor submitted my request to see a local surgeon for Roux-en-Y gastric bypass. The insurance company (United Healthcare POS Oregon)immediately returned that they would approve NOTHING to do with weight loss. They are denying me even the ability to see a surgeon. Anyone have any idea how to proceed? I have no recieved a denial letter as they refused even the request. (harmph.. :) Thank you for your input!    — TaraLong (posted on January 10, 2002)

January 10, 2002
I have United Healthcare but In Illinois and had no problems. I just found a surgeon on my own then he submitted the letter listing medical reasons for the surgery and they approved. They won't approve if they think it is for cosmetic reasons and not medical. I would send an appeal letter. There is a website www.obesitylaw.com Walter Lindstrom is a WLS advocate he maybe able to help get approval for you. Good Luck!
   — [Anonymous]

January 10, 2002
If you know which surgeon you want call his office for instructions. The staff will know how to best deal with your insurance company. Many companies reject the first request for WLS to try and discourage us, thus saving them money.
   — bob-haller

January 11, 2002
Hi Tara...I'm also with UHC in Oregon although I have a ppo plan. When I called the cust serv dept, they automtically said that nothing would be paid for. But then after a few more calls I spoke to someone else that was VERY helpful and said that once the docs send in their letters, and it's deemed not to be cosmetic that it'd most likely be approved. Talk to your surgeon about it! BTW let me know which surgeon you're going to..im interested in finding out! But remember one thing! Whenever you speak to the ins comps take down their names and write down everything that is said so that you have more ammunition to use against them if necessary to fight them. Definitely email me!
   — Ryan F.