From excited to total frustration!!

Well so much for my lap band surgery on June 26th.....at least that's the way it's looking right now.  After spending the last 6 months with my supervised diet, evaluations, sleep study, etc. we finally got everything turned into Cigna for approval.  The surgery itself has been approved.  However, Cigna is saying that Via Christi is out of network.  (this contradicts what their website and member services personel told me)  According to my policy, bariatric surgery is not even allowed the out of network benefits.  Zip, zero coverage if I go to Via Christi.        I'm hoping that there is a possiblity that since there is not another in network provider for the lap band within 100 miles of Wichita, they might have to allow me to have it done with in network benefits.  Two people with Cigna have told me this is what should happen.  Appearantly whomever Kate Jantz talked to is saying no......that it doesn't matter and I don't have coverage unless I go elsewhere.  Can they actually make you travel like that???  I don't know where to get that information, and haven't found anything that pertains to that in any of my insurance information.  Calling Cigna doesn't seem to help, as every time I talk to them I seem to get a different answer. 

I am going to Junction city for my Rny but my dr also does Lap band's also. If you can find another hospital would go to have it done?

I'm looking into Junction City.  It appears that Dr. Bollman is in network, and so is Geary Co. Hospital.  I would say that if I have to go elsewhere....this might be my best bet.  I'm still hoping that an appeal will allow me to have my surgery in Wichita vs. having to travel.      Who is your doctor? 

Hi, I had my RNY Gastric Bypass done by Dr. Bollman at Geary Community Hospital, and I just wanted to tell you he is a wonderful surgeon!!! He is very gentle, and never makes you feel rushed. He will answer your questions and has a fantastic bedside manner as well. Geary Community Hospital is also fantastic!!! They treated me like a queen when I was there. I always look forward to my trips back for checkups!!! By the way, I chose to drive 4 1/2 hours to go to Junction City, when I could have driven just a bit over 1 hour. I feel like you need to go where you feel you have the most confidence in your surgeon, and caregivers!! Good Luck Theresa

They told me Dr. Bollman doesn't do lap band???  That's why I'm having to now wait until August when the new surgeon gets there to have it done...backing up my surgery until late August or September.

Jeannee

Sorry to hear you are still having insurance trouble. They have been driving me nuts during this whole process. Kate also told me at first that my insurance didn't cover the surgery, but I had already talked to them and knew that they did, so I kept on trying and finally was able to get things straightened out. It does sound like you might have a case with there not being a provider within 100 miles. I would keep pursuing that angle. I knew that Wesley did have a program, because I did call and talk with them (that was who my doc originally referred me to). I guess I was assuming since they had a program that they were also doing the surgery there... Sorry for that assumption.

Sending you lots of well wishes and good vibes....

Donna

Well...turns out there is a big war going on between Wesley and Via Christi.  Wesley doesn't do the lap band...and won't be.  Seems they are atttempting to phase out even the gastric bypass at Wesley so that Via Christi has a monopoly on the market for all bariatric surgeries in Wichita.  To be quite honest, I do believe that Solutions for Life is a big cash cow for Via Christi.  The expense that I've had to invest through them already took me by surprise.  But I bit my tongue, knowing that I didn't have much choice in the matter if I wanted my surgery done locally. After all the confusion with my insurance....(and I am having to go to Junction City and LivLite by the way)....I wish I'd started with LivLite in the first place.  They have no $250 administrative fee....which I still shake my head at when Solutions for Life charged me that, as I've never heard of such a rediculous fee.  There is no charge for preop classes and education materials as they feel that's all part of the surgery itself.  There are no post op fees, etc....etc.   All in all, I figure I lost about $700-1000 to Solutions for Life, for nothing.  But oh well.....it's water under the bridge by now. My only disappointment now is that my surgery will be postponed until late August or September.  I've been approved for surgery, and now insurance is in the process of changing things from Wichita to Junction city, and thus in-network.  I'll have to travel back and forth, but I don't think that should be a huge issue as much as it is an inconvenience.

Yeah, I work for Via Christi and still have a hard time accepting the fees that they are charging. I hear other posters complain about a couple hundred dollars they have to spend for classes and such and I just want to scream. It has been very hard (I have had to charge a huge % of the costs), but I am determined to make this work and it will be worth every blasted penny if (when) it does.. Best of luck to you always!!

Sorry I wasn't more help!!

Donna

Tallgrass in Topeka does lapband, I am meeting with a surgeon on June 12th, this is just my first step.   I don't know about your insurance so I am not sure if they are in your network.   I am hoping that I don't have to do a 6 months supervised diet, (like that has ever helped)  I will only put on more weight.   

The supervised diet is all an insurance requirement...alot of them have it, but I'm sure it depends on who your insurance is with.  You can get all the information that your insurance requires by looking at their coverage position on bariatric surgery.  If it turns out that you do need it, drop me a line.  I've got a great form you can use that helped me to get approved for surgery in less than a week.  It includes everything on it....type of diet, exercise, behavioral modifications, drug therepy, and misc.....it just makes sure your doctor doesn't miss any required information on any month of the diet.