This really is an adventure...
...and I haven't even had surgery yet.
Ok so finally got all the various materials gathered and delivered to the surgeon's office for approval. The coordinator put the package together to send to CIGNA.. A week went by... denied.
Ok so you can imagine....I wigged out.
It took a few hours to calm down (and a 3-way with Haagen AND Dazs) to realize this is just standard operating procedure for 'da man'.
After calls and digging, the reason for the denial - which was not an official denial - was I was missing the 6 month diet notes from the doctor. Well that's crap. I was there every month. So I get a copy of the notes from said PCP and they are..... un-******readable. Like at least Chinese I could run through the Google translator. Not this chicken scratch.
So as I usually end up doing, I am taking matters into my own hands. I am creating, free-of-charge to my doctor, a weight-loss program/prescription form, which will have all the necessary components AND it will be typed, in actually legible characters.
Then I will march down to his office, have him sign them, and fax them myself to CIGNA.
I fully expected to be under the knife at the end of May. I took off from school, canceled all vacations, and generally rearranged my life to make this happen. And here we are July 8, and I'm not even scheduled.
Oh and about that Haagen-Dazs episode - it actually really helped me, as about 1/3 of the way through the pint, I understood exactly what I was doing. I stopped and put it away - at least for a few hours. When I split the rest that night with my other half - it was a very conscious decision.
Ok so finally got all the various materials gathered and delivered to the surgeon's office for approval. The coordinator put the package together to send to CIGNA.. A week went by... denied.
Ok so you can imagine....I wigged out.
It took a few hours to calm down (and a 3-way with Haagen AND Dazs) to realize this is just standard operating procedure for 'da man'.
After calls and digging, the reason for the denial - which was not an official denial - was I was missing the 6 month diet notes from the doctor. Well that's crap. I was there every month. So I get a copy of the notes from said PCP and they are..... un-******readable. Like at least Chinese I could run through the Google translator. Not this chicken scratch.
So as I usually end up doing, I am taking matters into my own hands. I am creating, free-of-charge to my doctor, a weight-loss program/prescription form, which will have all the necessary components AND it will be typed, in actually legible characters.
Then I will march down to his office, have him sign them, and fax them myself to CIGNA.
I fully expected to be under the knife at the end of May. I took off from school, canceled all vacations, and generally rearranged my life to make this happen. And here we are July 8, and I'm not even scheduled.
Oh and about that Haagen-Dazs episode - it actually really helped me, as about 1/3 of the way through the pint, I understood exactly what I was doing. I stopped and put it away - at least for a few hours. When I split the rest that night with my other half - it was a very conscious decision.
So, I am to understand that there will be no side dishes tonight? - Eric Cartman
Hey Sweetie!
Ya... just getting to the surgery can be quite a ride. Good for you for stepping up and doing what you need to do. I'm proud of you for taking the bull**** by the horns (so to speak.) And even more proud of you that you realized that some 3-ways rock but that one you had wasn't too rockin'. Keep your eye on the prize and your commitment right there. You'll get it approved and then you'll be on your way down the next road of this journey. You are very much already on it my friend!
big hugs to you!
~Maryn
Ya... just getting to the surgery can be quite a ride. Good for you for stepping up and doing what you need to do. I'm proud of you for taking the bull**** by the horns (so to speak.) And even more proud of you that you realized that some 3-ways rock but that one you had wasn't too rockin'. Keep your eye on the prize and your commitment right there. You'll get it approved and then you'll be on your way down the next road of this journey. You are very much already on it my friend!
big hugs to you!
~Maryn
Our little miracle baby boy is on his way!
you know i kinda ran into the same thing although with me, no one told me that they had to be 6 consecutive months for visits. so i ended up going 9 months before I could even have anything submitted and when my dietician gave me all she had, it really was all chicken scratches! I shrugged and sent them off to my surgeon. Luckily all the important components were just legible enough LOL Keep fighting....you WILL win :)
7-09 Thanks all for the support.
A positive update!
This morning I spoke with the nurse case manager at CIGNA. She was very nice and helpful and said exactly what I expected. She couldn't read the doctor's chickenscratch. She said FAX in a letter that summarizes the info and she can have me approved by Wednesday. YAY!
I am writing the letter myself and will send to the doctor's office.
And a another great session with my therapist today.
By the way, who's in the DC area? A job transfer is likely in my future.
A positive update!
This morning I spoke with the nurse case manager at CIGNA. She was very nice and helpful and said exactly what I expected. She couldn't read the doctor's chickenscratch. She said FAX in a letter that summarizes the info and she can have me approved by Wednesday. YAY!
I am writing the letter myself and will send to the doctor's office.
And a another great session with my therapist today.
By the way, who's in the DC area? A job transfer is likely in my future.
So, I am to understand that there will be no side dishes tonight? - Eric Cartman
Ugh.. that is frustrating. You know I have heard that denial reason so many times here. I was fortunate that my surgeon provided a "template" of the information that insurer's need for approval from these monthly office visits. I took that to my doctor and each month I made sure his notes had those items on them. I also asked for a copy of the physician notes each month. For those just now starting the process, consider doing this to avoid problems when it's too late. -- Tom
Follow my journey to a happy, healthy, active life at TomBilcze.com
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