SHBP CIGNA MEMBERS???
All of my testing (minus ekg and chest x-ray) is in a lump sun $1340 program fee. I can submit bills for reimbursement for this stuff, but I wonder if they''ll pay for any of it.
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I 
MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
Cigna is paying for everything. I've met my 1st $1000 deductible (thanks to $500 HRA, several little doc visits, and a big consultation with a hepatologist) and now I'm working on the out-of-pocket maximum (another $1000) where I'm only paying 10% of everything. Meaning...I picked up 3 drugs last week. My Walgreens bill was $1.71. I had a liver biopsy Monday (not WLS related)...I suspect it will cost $2500...so my portion would be $250. Next week are a pre-op clearance with a pulmonologist, an upper gi, and an appt with my rheumatologist...all I will only pay 10%. The week after is a pre-op clearance with a cardiologist...again 10%. This is until I hit that second $1000 out of pocket. Then everything will be free and clear. And at the rate I'm going (hepatologist and liver biopsy are putting this over the top, I'm sure) my WLS will be completely FREE!
I'm not sure I answered your question though, because you knew this already, right?
-TS
Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
did they pay your program fee?
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
My surgeon doesn't have a program fee. The only fee I had to pay was $250 and I think they say it's for processing your insurance. That, of course, was not covered by insurance or applied to my deductible. So, I can't help you there.
Hope I helped a little.
-TS
ETA: So, your program fee covers pre-op clearances with a cardio, pulm, etc? I have a sneaking suspicion that Cigna won't cover the program fee. If possible, you might be better off scheduling those clearances without the surgeon's office's help and doing the appts close to home.
Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
My surgeon doesn't have a program fee. The only fee I had to pay was $250 and I think they say it's for processing your insurance. That, of course, was not covered by insurance or applied to my deductible. So, I can't help you there.
Hope I helped a little.
-TS
ETA: So, your program fee covers pre-op clearances with a cardio, pulm, etc? I have a sneaking suspicion that Cigna won't cover the program fee. If possible, you might be better off scheduling those clearances without the surgeon's office's help and doing the appts close to home.
BTW I had an IDEXA scan the other day. It is the same technology they use on bigget loser. It scans your body and gives you a view of your fat/muscle/bone ratio. I am 53% fat! It was really cool. If anyone has the opportunity to do this go for it!
I also found out I have a high metabolism, imagine that!
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
I see. Okay, then I would suspect Cigna will reimburse for at least a portion of the program fee if they itemize each portion of it.
What exactly is an IDEXA scan? Why did you have one (if you don't mind sharing)? And did Cigna cover this?????
Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
It was NEAT. I'll try to post a website. Not sure if Cigna will pay for it, but I will submit and see what happens.
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
Not sure if this will come through, but it's a sample of a scan. I copied it from the Biggest loser website. Mine is in color the muscle is red and the fat is yellow. I can't wait to have less yellow.
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
JUST MY 2 CENT!!
LOLI TOO DON'T THINK INSURANCE WILL COVER PROGRAM FEES OR REIMBURSEMENTS, BECAUSE INSURANCE COMPANIES KNOW THE PROGRAM FEES ARE SOMETHING EXTRA THAT THE SURGEON CHARGES. BUT IF I WERE YOU, I WOULD CALL THE INSURANCE COMPANY AND HINT AROUND ABOUT THIS QUESTION WITHOUT LET THEM KNOW THAT YOU PLAN ON TRYING TO GET REIMBURSED.
I HOPE, I HELP
YOUR GFF
Wanna know about my type of surgery?
Visit www.dsfacts.com 
IZZY
HW/338 SW/321 CW/205 GW/185
(20 lbs from my goal!!! YaY!!)
JUST MY 2 CENT!!
LOLI TOO DON'T THINK INSURANCE WILL COVER PROGRAM FEES OR REIMBURSEMENTS, BECAUSE INSURANCE COMPANIES KNOW THE PROGRAM FEES ARE SOMETHING EXTRA THAT THE SURGEON CHARGES. BUT IF I WERE YOU, I WOULD CALL THE INSURANCE COMPANY AND HINT AROUND ABOUT THIS QUESTION WITHOUT LET THEM KNOW THAT YOU PLAN ON TRYING TO GET REIMBURSED.
I HOPE, I HELP
YOUR GFF
They have great technology, and do extensive testing, well beyond what any other surgeon I have researched is requiring. They are EXTREMELY thorough.
For my health and security, it is $1340 well spent! This is something I am definitely NOT looking for a bargain rate for.
The best price is not always the best for you! Especialy when your health is concerned.
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
