Welcome guest, you have 1 message! Register

Results 1 to 4 of 4
  1. #1
    Gastric Sleeve Member Njo's Avatar
    I have not had a gastric sleeve.
    Name
    Neal
    Surgery date
    07/24/2019
    Surgeon
    Dr. Ayoola
    Join Date
    Jan 2019
    Last Activity
    01-23-2020 09:17 PM
    Location
    Frisco tx
    Posts
    16
    Said "Thanks" 19 Times
    Was Thanked 7 Times in 6 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Insurance issues

    Hey Guys,
    Im so so pissed and deflated..Ive completed my required obstacles per Insurance and Doctor requirements, so I thought. I was initially told that my UHC insurance required 6 dietician visits, enrollment into the Optum Bariatric program, a stress test and EGD (Doc requirements) and now, at the very last minute (my documents were going to be sent for approval to UHC this Friday) Im being told by the UHC Bariatric devision that one of the additional requirement is that I have a documented weigh in thats at least a year old. I do not meet that requirment, the best I can provide them is a weigh in from Last October. I had this surgery all set up for June and Im extremely disappointed that I most likely will not meet their requirements now till October. Im also pissed at my Docs office for not knowing this requirement in advance because I would have probably just self paid and got it over with..Just wondering if anyone had an experience with insurance like the one I am going through? Thanks in Advance, God Bless, Neal



  2. Gastric Sleeve Surgery With Weight Loss Agents
  3. #2
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
    Name
    Christie
    Surgery date
    11/03/2016
    Surgeon
    Dr. Wright
    Join Date
    Nov 2016
    Last Activity
    09-12-2019 04:13 PM
    Posts
    5,169
    Said "Thanks" 978 Times
    Was Thanked 2,939 Times in 2,191 Posts
    Said "Welcome to Gastric Sleeve" 1,465 Times
    Blog Entries
    97

    Default Re: Insurance issues

    Ugh. That really is shitty. The surgeon's office should know better. Is it possible to use a weigh in from a primary care visit? It does not hurt to ask. I will keep you in my thoughts and prayers that something works out and you get approval.



  4. #3
    Gastric Sleeve Member Njo's Avatar
    I have not had a gastric sleeve.
    Name
    Neal
    Surgery date
    07/24/2019
    Surgeon
    Dr. Ayoola
    Join Date
    Jan 2019
    Last Activity
    01-23-2020 09:17 PM
    Location
    Frisco tx
    Posts
    16
    Said "Thanks" 19 Times
    Was Thanked 7 Times in 6 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Insurance issues

    Quote Originally Posted by Christie13 View Post
    Ugh. That really is shitty. The surgeon's office should know better. Is it possible to use a weigh in from a primary care visit? It does not hurt to ask. I will keep you in my thoughts and prayers that something works out and you get approval.
    Hi Christy, Unfortunately, I didn't have any visits to any Providers for the past few years prior to October 2018;( I think two years ago would be the only documentation that would be available however, my BMI was under 35 so not sure if that would work for the insurance requirement. Thanks so much for the prayers and perhaps theres a reason for all of this..



  5. #4
    Gastric Sleeve Member Bellagirl's Avatar
    I have had a gastric sleeve.
    Name
    Lisa
    Surgery date
    03/27/2019
    Surgeon
    Corrigan McBride
    Join Date
    Mar 2019
    Last Activity
    03-30-2020 06:39 PM
    Location
    Omaha, NE
    Posts
    143
    Said "Thanks" 134 Times
    Was Thanked 84 Times in 58 Posts
    Said "Welcome to Gastric Sleeve" 203 Times

    Default Re: Insurance issues

    I ran into the same situation 10 yrs ago with my LapBand. Completed all the requirements including a 6 mo wait before surgery only to find out I needed 6 months of documented weight loss attempts from my primary doctor. As I had not seen her for over 6 months, I didn’t have any notes in my chart to indicate I had seen her monthly during process. I had to wait a total of 12mo to get the surgery and 3 yrs later the band no longer worked for me, it was a waste of time waiting. I agree with you that the surgeons office should have known in the beginning and advised you to complete that part of the requirement ASAP. I wish you good luck and hope your approval comes through.



Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •