Guess I should re-introduce myself...

Hi there!  I am Suzanne, and I officially began my WLS journey last November.  I completed all the appointments necessary and Dr. Harris' office submitted the paperwork to CIGNA (sigh!) in mid-May.  Actually, the first submission was sometime in mid-April, but CIGNA has apparently been losing it.  Then Dr, Harris' office added some more documentation in mid-May.  On Thursday, I received a copy of a letter sent by CIGNA to Dr. Harris informing us that they did not approve the surgery.  Turns out, this time, some case worker just closed my case!  SOOOOOO....  it has been re-opened and we are asking them to ru**** and we hope to have a decision by Monday. Actually I am pretty sure they will deny it again, as I have not completed the 6 consecutive months of supervised and recorded weights by an MD that they want.  Still have an appt in early July as well as one in early August.  Then it will be complete. But I am going to take this one step at a time and enjoy this moment, knowing that I am at yet another step in this process and that one more milestone has been passed!

Suzanne, Welcome to BMI over 50. Dealing with the insurance can be grueling. Stay on top of things and just a idea try to get copies of everything so you will have your own set. Loved your pics looks like an ideal spot to fish.                           Annie

Thanks Annie!  Actually I think my BMI is right around 40, but who's counting, right?  LOL Thanks for the comment about the pic.  It took a lot of courage to post it!  I remember how dismayed I was when my friend gave it to me.  I just could not believe I look like that! Yes it is an ideal spot for fishing.  My house is on Black River in Pender County and I was actually fishing off my pier with friends when that shot was taken! Thanks again, Suzanne

Hi Suzanne - I am one of Dr. Harris patients also. I am in the final stages before my WLS too.  I just wanted to say hello...and welcome! :O) Mare

Thanks, Mare!  I have seen your posts and saw that you were also one of Dr. Harris' patients.  Do you have a date yet?

Hi Suzanne- Sounds like you've had some troubles for sure. Hopefully you will hear something soon. Best Wishes - Wendy

Hi Suzanne, I feel for you. I went through something similar with aetna. I did the full six months with all of my doctor visits and tests only to get denied. I was in Connecticut at the time and ended up getting the state involved and even emailed the govenor...that was fun. No one it seemed could make aetna cover the surgery. I got lucky, sort of...my company got sold which eventually led to me being out of a job but that's another story, the new company had insurance that covered the surgery. Not very reassuring I guess, but just believe and it will happen. Best wishes, Joe

Thanks Joe.  Y'know, it's funny... I have not had any doubt that I will ultimately gain approval for this surgery since that first consult I had with a nutritionist back in November (see my profile).  Since going past that obstacle, I know that it is just a matter of when, of waiting them out.  They are hoping I will either give up or die.  That is just the sort of game insurance companies play.  It will all work out just the way it is supposed to.  And congrats on your progress.  VERY impressive!

I should find out on July 3rd. Will keep you posted.

:O)

Mare