CALLING ALL PRE OPS WAITING FOR INS APPROVAL

Lets keep in touch. We can wait anxiously together! Let us know at what stage you are in getting approval. When was your request submitted? What insurance company? What surgery are you attempting to have. Also post when you get your answer! Send good energy to all the decision makers at the insurance companies.....

Dr. KESHSIAN got all of paperwork today. Kristina in his office said they would be submitting for approval today or Monday. I have CIGNA PPO. They have been very good to me in the past hopefully my luck hasn't run out! Dr. K states i have a very strong case for having the ERNY to DS revision. My diabetes is on its way back to the surface. My hemoglobin A1C has gone from 4 to 6. Im wondering is there anything i should about letting CIGNA know i dont plan on having the sleeve i was approved or with that dr? OMG they may deny because i already have an approval with a different dr. For different surgery. Humm

I was able to change both my surgeon and surgery type after initial approval. Good luck!

What insurance do you have? How did you go about getting the change? Did you call the insurance company and let them know?

I have united and had been tied up in appeals for 5.5 months. My surgeon handled the change. I was worried about the change in procedure code given the appeal but it was ok.

Oh ok for some reason i don't think It will be that easy since Insurance companies have a stricter set of guidelines when it comes to approving a DS. Cignas criteria is you have to have a bmi of at least 50. Mines is 46. Dr said he could make a good case for me revising from distal RNY to DS.

I have United Healthcare and am waiting for my approval from them.  How were they to work with?

I have UHC and I found the experience to be pretty good.  I looked up the coverage through myuhc.com and called them and notified them of my intentions.  They took my info and said a nurse from their Bariatric resource would be calling me.  The nurse made contact and we went over their requirements (psych, 6 mo supervised) and that they require a Center of Excellence.  I worked with the coordinator of the program I'm going through and met all the requirements and just got my approval for Oct 7 last week.  During the 6 mos supervised portion the bariatric nurse contacted me to see how things were going.  They were pretty no muss no fuss.  The nurse on their end was very nice and had useful advice.  I hope your experience will be similar!

 

Jen

I too am waiting to hear back from insurance.  It has been almost a month and it is driving me nuts!  I have medicaid....will they send me a letter or what am I to expect?  Waiting!...Good luck, I am new to this and trying to just get answers...peace of mind!

Every company may be different. When i got my approval they sent the answer to my dr and sent me a letter in the mail. The dr knew well before i got my letter in the mail. Plus with CIGNA you can call to see if there is an answer or at what stage your request is at in the process.

 

What surgery are wanting?

Hi there!  My doctor told me I would do best with the bypass....I wanted vertical sleeve, but I am at the point I don't care.  i never thought about calling the insurance to see my status.  Thank you!