How will I find out if UHC approves/denies me?

I go for my 2nd consultation with my surgeon next week.  I've already completed both my psych and nut evaluations.  He told me to bring husband with me to this one.  Therefore, I'm assuming and hoping this is the consultation where they will go ahead and submit my Lap Band request to United Health Care.   Does anyone know how UHC lets you know if you're approved or denied?  Will I hear from them directly or from my doctor's office?  Do you know about how long they take to respond?  Also, do you think it would help my cause by me sending in a letter I personally wrote, giving detail of my battle with weight, how it's impacted me and my family, etc.?  In addition, I have my Chiropractor submitting a letter, as well as my PCP.  Does UHC take any of this into consideration when deciding? I'm sorry for all the questions.  I'm just sooooo excited and really, really nervous!! Thanks, Melissa

Hi, I also have UHC (choice plus) and I just got my letter today in the mail. I went in to see the Dr. on April 14th and they submitted the letter to the insurance the next day ( the 15th ) and I received my confirmation letter in the mail today ( April 26th ) so now I have to wait PATIENTLY until I can call the dr.'s office to schedule my surgery. I didn't have to submit any letters and I didn't even have to call like so many others have had to do. I am excited for you also. I will pray that you get your letter soon also.

Thanks, Kasha! I really appreciate your reply.  I am so excited, yet too nervous to get excited!!...lol!!!  I've heard soooo many horror stories, yet soooo many aswesome stories about UHC!  I really hope I'm one of the "awesome" stories!  I'm glad you are! Let me know when your surgery is scheduled.  I will send positive thoughts your way and strong prayers! Thanks, Melissa

Unfortunately, I'm one of the "horror" stories from UHC. They denied me because I could not document 5 years of morbid obesity ( I could give them 3.5, up to the present). It was due to a lack of weigh ins at the doctor, because I was seeing him pretty much only for my back at th time, and he now is no longer practicing. I was able to provide them with quite literally a lifetime of documentation of obesity, but it wasn't enough. I'm going through the appeals process now.


Best of luck to you.

Michael, I am so sorry to hear that.  Best of luck with your appeals!!  You know what they say, persistance pays off!!  It can still be a pain in the butt though. I guess I'm probably screwed on the weigh-ins then.  I have always had such a tough time dealing with my weight that I wouldn't let the nurses weigh me most of the time, when I had office visits.  In addition, I haven't been morbidly obese, (consistently) for 5 years.  My weight has gone up and down consistently for 5 years though.  We'll see!  Wish me luck!! By the way, have you heard of/contacted the "Insurance Guru" Vicki?   Thanks, Melissa

I was talking to a woman from the doctors office, and she told me of a case where UHC denied surgery because there was no weight record, and it was because the patient was so heavy the scale in the doctors office couldn't weigh them! I guess they will use any technicality to get out of covering.

The State of CT has an insurance advocacy program that is helping me prepare the appeal, along with the doctor's office. We'll see what happens.

I have UHC.  I also had the 5 year documented weight history requirement.  I also had the fear of being weighed in before I considered having surgery.  I've also had UHC for longer than 5 years, and in the "personal history" section of myuhc.com, they keep a list of all the claims they have received from the individual doctors.  In my case I was missing the years 2003 and 2004.  Turns out I didn't need 2003 because all you need to do is document one weight showing a 40+ BMI for 5 years.  (2008, 2007, 2006, 2005, 2004)  I knew I would be denied without 2004- so I called up a doctor I had seen for strep throat of all things, I said "I was in that office on such and such date, and I am looking for a note from the doctor saying I weighed such and such at that appointment."  It sounds bold, but it did work.  I got a fax from the doctor.  I got the advice on this site, actually, from Bonnie- don't send them your life story.  One weight from each of the years, from a doctor's office or at the very least a lab.  Highlight the date & your weight, and give it to your surgeon.  My approval came through in less than a week, and my surgery was one month ago today.  Best of luck!!   Oh PS (edit)- I never found out whether they approved me.  I called them myself, and evidently my doctor's office received the necessary approval.  It's easy enough to find out if you're approved, if you get the code for your procedure, have it handy when you call to ask.

UHC required a 40+ for 5 years? With or without co-morbidities? I'm just wondering because I'm 36-38, depending on who I see. I have co-morbidities, but I haven't even made it that far. My denial is due to an employer exclusion. However, my company changed their policy two years (according to UHC) after giving every employee a benefits binder and telling us to hold on to it, rely on it, and update it with any new documentation that came out. No change was ever sent out to us, and the copy WE have shows an Exception to the Exclusion. I'm hoping to get past that hurdle, but now I'm wondering if I have another after reading our post. I had to call for my determination, too. I have no letter yet to refer to. Only what I was told.  Anyway, thanks for your reply, too, and congrats on your success!