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Hi Everyone,
I've been getting conflicting information on what UHC requires in terms of documentation for weight loss surgery. Do I need 6 months of physician supervised diet notes? Do I just need a note from a physician? I've been obese for over 5 years now and before my senior year of college was recommended for weight loss surgery but then I left for school and now it's a year later and i'm finally ready but I think the 6 month supervised diet thing is going to hold me up. Any suggestions? I have documentation that I've worked with a trainer/nutritionist and have done weigh****chers twice in the past 2 years - more if I go back further.
Thanks!
Many thanks to Dr. Alvarez for his latest episode of Obesity Chat.
You can upload it from www.obesitychat.com or the latest episode's direct link is:
http://guillermoalvarez.podomatic.com/entry/2014-07-09T09_53 _17-07_00
I just found out, don't know how I missed it, that I could take out a loan from my 401k plan and that is how I'm financing my surgery. As soon as I receive the funds, I will be scheduling my surgery with Dr. Elias Ortiz in Tijuana.
I'm so excited I can't stand myself right now!!!
The ObesityHelp Conference 2014 is about education and information for living a healthy lifestyle with weight loss surgery. In addition to the Grad Panel Q/A, Professional Panel Q/A, Fashion Show, no charge professional quality Pixel Photo Booth pictures, free plastic surgery consults, a Meet & Greet and Keynote Speaker Graham Elliot, MasterChef Judge, here's the 4-1-1 on the sessions at the Conference:
● I'm Changing and I'm Perfect As I Am
● Dealing with uncomfortable food situations and social settings after WLS
● The importance of support on your WLS journey
● Reading Between the Labels: How To Outsmart Your Groceries
● How Much Does a Zebra Weigh? (Yes, you'll find out in this session)
● Re-Defining Success After Bariatric Surgery
● Six Steps to Success When Coping With Addiction after WLS
● What To Do After the Honeymoon is Over
● Exploring Your Reconstructive Plastic Surgery Options
● What To Expect When You're Expecting.....Surgery to Work
● Sex, Intimacy and Relationships after WLS
● How Yoga supports your WLS journey
From attending the Conference, you'll take away things you've learned that will help you live a healthy lifestyle, friendships that you'll have made, lots of vendor samples and a goodie bag, photos and memories that you'll cherish for a long time.
The countdown to the Conference is ON......buy your tickets now - you'll be glad you did!
Kim Gyurina, Event Manager
get the policy itself and read it. or call insurance co directly. diane
Join US On The VSG Maintenance Group Forum!!
http://www.obesityhelp.com/group/VSGM/discussion/
I keep getting different information. One tells me bariatric surgery is excluded and the doctors office says it is not, plus other employees have had the procedure done.....can someone help?! Please!
317/287/170
Most group contracts do not have specific medical policy language within the contract. They will use terms that refer back to the published medical policies. The primary exception is for union negotitated contracts which can *sometimes* spell out in the written contract what CPT and ICD codes are covered and which ones are not. There are good and bad points to each scenario. As an example most benefit booklets do not specify under what cir****tances they cover an MRI of the breast, but I can pretty much guarantee you they do not cover it in place of a routine mammogram.
If they were to list all the criteria in your benefit booklet in specific unambigious terms it would probably be over one thousand pages long ;)
I've never seen a copy of a benefit booklet from UHC, but search anywhere for the term medical policy, or any reference to the term medical necessity. UHC uses the term 'unproven' in their medical polcies so they might use that phrase as well.
I already have a wonderful bariatric surgeon who, in March of 2013, did a gastric sleeve on me. I lost a lot of weight, but then I hit a wall and could not get away from somewhere between 360lbs-375lbs. I have crippling osteoarthritis in both knees and have been told that I really need to lose weight and have a bmi of 35. Currently, it is 55. My surgeon now suggest that I have a gastric bypass, which , at first I was scared, but I am now committed to doing it. However, I had Amerigroup (medicaid hmo) the first time, Now I have UHC star plus (also a medicaid hmo). They will pay the surgery, but my surgeon needs a surgical assistant which medicaid won't pay for. What do I do?
For OH community members celebrating the July 4th Independence Day...We hope you have a happy and safe holiday.
Hi Nan I was just informed today that I was denied my surgery. Can you please email me the letter of appeal so I can start the process. My e-mail address is [email protected]. I would greatly appreciate it. Aetna is saying that I didn't meet the criteria for the 90 program. They stated that they only had documentation for 56 days which is untrue because my surgeon would not submit before 90 days! Please help me! Keerah
Hockeymom87 · 0 replies · 810 views
