Surgery approved but for only 90 days?

Hello Again - I just received two letters from Cigna, one denying my surgery and the other one approving it. Now, Dr Blackstone's office already called me last week stating my surgery was approved. So, I'm not sure why I received one letter stating I was denied. Anyway, I noticed on the approval letter that I am approved for 90 days and only if I have the same insurance coverage at the time of surgery. Is this typical? As I'm sure most have heard by now that Dr Blackstone is scheduling surgeries out 4 1/2 months. She is sooo far behind due to losing the other doctors and the two new replacements don't start until July. Does anyone know what happens in this situation? I'm wondering if you have to submit for approval again. Just curious! If you read my earlier post, I am going through some issues regarding my insurance switching from Cigna to UHC. However, I am extremely excited that I was approved to begin with! I am thankful that there are such wonderful people here on the OH boards. Everone seems to truly care and encourage you to keep going & stay positive. It really does help you get through the rough times! I keep telling myself that it will all workout in the end. But I have to admit that I'm still a little worried. It's been such a long and expensive road to get approved and now I may have to go through it again with a new insurance company. It's very tiring! Take care, Michelle

From what I've been told, Dr. B isn't accepting UHC after June. Now that may change with these other doctor's coming on, but it's hard to say what will happen in your case. It sounds like yours will be changing over about the time she won't be accepting UHC. She's even more backed up right at this time. She's had a family emergency and had to cancel some surgery dates and move some pre-op appointments. I'm one of the pre-op people. I don't even know if my surgery date of the 26th will be kept. Like you said, if it get's moved, how far out will it go.....I had to move one in November, this is the changed to date! My husband had his done by Dr. B in November and I'd like to have mine done as soon as possible. If they try to move me too far out I'll go to another surgeon. I hear Dr. Juarez is excellent, so we'll see. Four and 1/2 months to wait is a bit long....but it's up to you. She is a highly rated doctor and the Scottsdale Hospital was wonderful. It even has a spa!

LOL about the spa Carole. I had forgotten about the complementary massage! That was awsome. At least the until I fell asleep I was only two months out for Dr. Blackstone also and I remember thinking that was a long time out to schedule (even though the time actually flew by to quickly). So 4-5 months does seem an impossible long time to wait. I know when I decided to have this surgery I wanted to get it done, I didn't want to wait around. So sorry to everyone who is getting bumped and having to wait. I can't imagine your frustations and disappointment. I sometimes think it was a blessing that I didn't have insurance, as I would still be waiting along with you. Especially when I hear stories of people fighting with their insurance companies for up to three years to have these surgeries. I hope things turn around for all of you quickly.

I had my surgery done by Dr. Juarez. He's great, and Banner Good Sam gave me excellent care (i lucked out with private room!) and the nurses there were great. My only complaint is that Dr. Juarez doesn't have much in the way of post-op support. Andrea, his lap-band nurse, has just started lap-band only support group meetings once a month, but his Bariatric Center has a ton more classes/meetings for bypass patients...seems to be taking a while for banding support to catch on...it's been hard to get info, answers to questions, etc, if you had the band instead of the bypass surgery ....

I just went and looked at my approval letter and it was good for 90 days also. Have you heard from your Case Manager from Cigna yet? Maybe give them a call, you should have a nurse assigned to your case now with your approval. Call them and ask their advice on what to do with the surgery date... I am shocked Dr. Blackstone is not almost 5 months out. When I got scheduled, it was 2 months for me. With alot of Bariatric surgeons leaving the valley (Barix Center closing, Wish Center, etc) the demand is high and very little surgeons left I guess. I know SBC has a huge amount of patients and it will get better once she gets the two new doctors in July. My friend was looking into having surgery with Dr. Blackstone and he has the same situation with United Healthcare, he is going to do all the pre-op testing with SBC and then see if he can get in with another surgeon. But I think he really wants to stay with SBC because of the educational classes and the support services after.

My first approval letter didn't extend far enough to reach my surgery date so Dr. Blackwell's office had the insurance make the adjustment. As to the issue with UHC, that is something else all together. If you have to change doctors, get copies of all your test results, etc. and transfer them. You shouldn't have to repeat the tests anyway. I fear this situation with the very long waits will not improve until new partners are brought in. I wonder who is covering her patients that were in the hospital when she was called away or who might have complications and need her. Good luck!

Michelle, At the time a doctor's program submits to any insurance; they are required to give a surgery date. These are usually bogus dates but necessary to play the game. Then, when a real date is later than the one submitted; it is usually just a quick phone call from your surgeon's office with the right coding to get it extended. Your switching insurances would concern me though too......follow up care is soooo important that first year especially. Good luck! Joyce