X posted: I AM APPROVED!!!
Here is short synopsis of my WLS journey:
July 2000 RNY with Steven Olchowski in NC
2005 Olchowski lost his license in NC for performing variations on the RNY, even mini gastric bypasses
2006 I start having internal bleeding issues---26mths, 3 colonoscopies, 3 endoscopies, 1 camera endoscopy, and a CT scan later---it was found that I had 2 hernias and one had ripped a tear in my intestine (surgery 2008)
April 2014 my sister shared that she is seeking wls, I started scouring OH website for info for her and I learned revisions were possible
June 2014, saw my PCP and she was agreeable to helping in any way she could
August 2014 I picked up CIGNA as my primary insurance thru work
(as Tricare was our family insurance and has a once a lifetime policy for wls)
Oct 2014 Met with Dr. Folahan in TX (8 hours from my home)
November 24th packet sent in for pre authorization to CIGNA
December 4th denied by CIGNA because of no proof of compliance with post op (argued that all of that was lost when he lost his practice in NC) and because my BMI is 46 and not 50 or greater
Jan 5th sent my packet of information to my surgeon to begin the appeal process
Jan 16th peer to peer done; APPROVED!!!!!
There is no expiration date on my approval letter, according to surgeon’s office, and they did not submit a date with it. I am praying for June 10th, summer break, so that I can have time to heal and take care of myself, learn my new body and new insides before going back as a high school teacher.
Office mgr is going to set it up for that, and hope that it all goes through well!
YAYAYAYAYAYAAYAYAYAYAAAAAAAA!
Thanks for all of your suggestions and support!
Shelia
