Bummed

I just got a call back from Dr. Kim's office. The insurance department doesn't think that I will be approved by Cigna since my BMI is 37.1 and I technically don't have any co-morbid conditions. I do have insulin resistance, but not quite diabetes. She gave my the self-pay price for the procedure and said that I should go to the seminar on Wednesday night and try to ask Dr. Kim if he thinks I would be able to have the procedure by his own criteria. If he says yes, then I can schedule an appointment as a new patient ($295). Then I would need to establish financing before I could schedule an appointment for a psych eval with Dr. Ferguson. If she passes me, I will move on to the Nursing Assessment where I will get information on the labs and tests that I need to complete. Once those are done and turned in, we can talk about a surgery date. Kristen-I hope you read this. I was told that you were the person to contact about financing options. I would like to know what my options are here. Eli-Where are you at in the process now? Ali

Ali- When was the last time you had a complete physical and have you had a sleep study done?  Do you have any mobility issues, or pain in your weight bearing joints or back?   Red

I have labs done regularly because of my insulin resistance and high cholesterol. I just had them done this month. I do not have sleep apnea or joint pains either. Ali

Hi Ali,

Don't give up! High cholesterol is a co-morbid condition. Do you snore? Toss and turn? Feel well rested after a nights sleep? Restless sleep?

Kristen

Ali, I am so sorry. I wish you good luck on getting finance for self pay.

I hate to state the obvious...but have you actually measured yourself?? My PCP did and I was a full inch shorter than I had thought. Of course, that raised my BMI.  Like someone else suggested, have you had a sleep study? When's the last time you had a full work up for your insulin resistance?  Best of luck Ali!

So, a quick update... I contacted Cigna to see if they could tell me if insulin resistance would be considered a co-morbid condition...they said YES. I even got him to fax me the letter stating that! I just sent the letter and an email to Amanda at Dr. Kims. She said that if there was a possibility that I would be approved they could try to get some type of letter from Cigna that would allow me to go to Dr. Kim's even though it is out of network. Not sure how they do that, but I really hope it works. If I can not go to Dr. Kim's due to being out of network then I will be going to Dr. Jawad in Ocala. I guess there is still hope in getting this covered! Ali