I was told that it takes 2-weeks sometimes up to 1-month to hear back. Hang in there! you will know soon. Don't let anything distract you from your goal.

I was a prior authorization nurse for UHC. First, the request goes through intake, where it's then sent to a nurse "queue", where it waits for a nurse to get to it. No one likes doing bariatric pre auths because they're so much work, so they may sit in the queue a little longer than other, easier cases.

Then, once a nurse gets hold of it, she has to write it all up, read all the doctor's notes, make sure all the requirements are done, the dates are correct, etc etc.

THEN, the nurse passes it over to the medical director for the final yay or nay, which, again, goes into a queue and waits till a medical director gets it to work on.

Some doctors know how to send all the paperwork in so that it's easy to go through and figure it all out. Some doctors send everything in all hodge podge which takes the nurses forever to find all the correct documentation. Plus, each state has it's own set of requirements for bariatric surgery, so if the nurse working your case isn't familiar with your state's requirements, it takes that much longer to get it all together.

Then, once it comes back from the medical director to the nurse with the yay or nay, the nurse has to notify the doctor's office of the decision, and there are specific form letters to use for this, plus they call the office, too.

Anyway, that's how it was done at UHC.

ps. of all the WLS pre auths I did, only one came back denied, and that was because the patient was totally non compliant with the pre op diet and the psych consult showed that the patient was totally unrealistic about everything!

Found out yesterday that I was approved! Just waiting for scheduling to contact me to get a surgery date. I am so excited but yet nervous at the same time. I am sure that is normal I mean this is a HUGE lifestyle change. I will update my profile as soon as I get my date!

Originally Posted by andersal

Found out yesterday that I was approved! Just waiting for scheduling to contact me to get a surgery date. I am so excited but yet nervous at the same time. I am sure that is normal I mean this is a HUGE lifestyle change. I will update my profile as soon as I get my date!

Yay!!! I'm pretty sure I was literally jumping for joy when I got the approval
.