P2P Call Guide

How to Win a P2P Call for Bariatric Surgery Denied by UHC

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when UnitedHealthcare denies Bariatric Surgery (CPT 43775, 43644, 43846).

Why UHC Denies Bariatric Surgery

BMI does not meet threshold

Supervised weight loss program not completed

Psychological evaluation not documented

Comorbidities not adequately documented

Know UnitedHealthcare's Criteria

UHC uses InterQual criteria and their own Clinical UM Guidelines (CG series). Medical directors are typically accessible for P2P within 5 business days.

Key policies to know:

  • Requires eviCore for MSK and advanced imaging prior auth
  • Clinical UM Guidelines (CG series) are publicly available online
  • Prior auth through Optum/UHG portal
  • Known for strict step therapy requirements on biologics

UHC's Specific Approach to Bariatric Surgery

Applicable Policy

UHC Clinical UM Guideline CG-SURG-38 (Bariatric Surgery)

How UHC Typically Denies This

UHC requires a 3-6 month supervised weight management program with monthly physician visits, dietary counseling, and documented progress. The program must be completed within 2 years of the surgery date.

Your Strategy for This Payer

The most common denial is incomplete supervised weight loss documentation. Ensure every monthly visit is documented with weight, dietary compliance, and behavioral modification progress. UHC also requires psychological clearance.

Key Phrase to Use on the Call

"The patient has completed [X] months of supervised weight management with monthly documented visits per CG-SURG-38, along with psychological clearance and nutritional evaluation, meeting all pre-surgical requirements."

Building Your Medical Necessity Argument

Document BMI >= 40 or BMI >= 35 with comorbidities

Show completion of 3-6 month supervised weight loss program

Include psychological clearance and nutritional evaluation

List comorbidities with supporting clinical data (A1c, BP, sleep study)

P2P Call Tips for UHC

Reference UHC's own Clinical UM Guideline number (e.g., CG-SURG-71)

UHC medical directors respond well to InterQual criteria language

Be specific about which InterQual subset applies

Have the CG policy number ready -- shows you've done your homework

Guidelines to Reference

  • ASMBS/IFSO Guidelines for Bariatric Surgery
  • NIH Consensus Statement on Bariatric Surgery

Relevant CPT Codes

CPT 43775CPT 43644CPT 43846

Specialty: General Surgery

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