Guest guest Posted October 18, 2001 Report Share Posted October 18, 2001 Hey All, My insurance (United Healthcare) just called and said that we got ahead and overlooked something. Now they denied me because I would be going out of network and I have out of network benefits, but excluding morbid obesity. Basically, I can have surgery, but I need to stay in network. I said give me the # of a surgeon doing the DS in network. She said they don't have one in-network which was the only reason I was going out of network. I talked about inadequate coverage and she said that won't work because they allow me to get the RNY in network. I don't want the RNY. I know people have gotten around this, but I need to know how. Please help or direct me somewhere for help! Thanks So Much, Tyner Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2001 Report Share Posted October 18, 2001 Gosh all of this UHC stuff!! I hate them for the trouble they give people.. look at your certificate of coverage. .dont just take their word for it.. you should have gotten a book that gives all the details.. My hand book says on page 20, section 9 titled " Referral Health Services Rendered by Non-Participating Providers. In the even that specific Health services cannot be provided by or through a Particiapating provider, you are eligible for Coverage of Eligible Expenses for Medically Necessary Health Services obtained through non-Participating providers. " Check yours to see if this is there.. if it is.. your home free. I'll give you a copy of my approval for 100% paid as in network that was out of network because there is no DS surgeon in network. > Hey All, > My insurance (United Healthcare) just called and said that we got > ahead and overlooked something. > Now they denied me because I would be going out of > network and I have out of network benefits, but excluding morbid > obesity. Basically, I can have surgery, but I need to stay in > network. I said give me the # of a surgeon doing the DS in network. > She said they don't have one in-network which was the only reason I > was going out of network. I talked about inadequate coverage and she > said that won't work because they allow me to get the RNY in > network. I don't want the RNY. I know people have gotten around > this, but I need to know how. Please help or direct me somewhere for > help! > Thanks So Much, Tyner Quote Link to comment Share on other sites More sharing options...
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