UHC Pre-Auth... how long for approval?

nmprovo

Anyone with UHC? How long did it take for them to approve/deny your surgery after pre-authorization was requested? My surgeons office just submitted mine on Thursday and UHC said it could take up to 15 calendar days for a decision! I’m losing it over here... wondering if 15 days is the norm or if it’s usually less.

Mavericksmom

UHC is my husband's retirement benefits insurance carrier from his former employer. I had it as secondary insurance for years and last year they denied a procedure I needed that was approved by my primary insurance, from my employer. I had to appeal and it took several weeks. I was so angry because it was pointless for them to deny in the first place because they weren't my primary insurance. I had to get them to reverse their decision or risk being held accountable for thousands of dollars. They finally approved it, and my primary insurance paid their share and UHC never had to pay anything! SOOOO, frustrating!

On the upside, I switched to the retirement benefits UHC Medicare Advantage Plan and dropped my employer insurance later last year when I turned 65 and they were great paying for all my breast cancer expenses.

I am surprised that they needed pre-authorization for breast related surgery, unless you are having it done prophylactically, because the laws mandate that insurance pays for BC surgery and reconstruction.

I know it is upsetting, but when they denied my procedure (not for breast cancer) it only took a week, the appeal could have taken 30 days, I faxed them everything they asked for and that took about two additional weeks. It would have gone faster if my doctor had sent what was required in a timely fashion!

I wish you luck, it can be soooo frustrating! Medical insurance is such a mess! Also, when I got my EOB from the insurance company after my breast cancer treatments and follow up tests, some things were denied. When I inquired, I was told not to worry unless I get an actual bill. My sister who runs a medical out patient facility said if a lot of claims come in for a patient in a short time period, insurance companies will deny some tests, etc, and the medical facility will resubmit the bill and it will get paid. That way the amount of money they pay is spread out over a longer period of time.

Again, I know it is so hard to wait, but I suspect you will hear from them by Wed. of this week. Good luck!

MoonGirlJess

Not long for me. The drs office always knows before I do but I get a letter in the mail in about a week to 10 days onthe status.