HELP PLEASE!!!!!!!!

ler0719
on 11/1/07 4:41 am - NY

Ok, so here is my dilemma.  I have Cigna and they state that you must have 6 months of supervised weight loss.  I went to the doctor in March to begin weight loss and then I started looking into WLS.  I began to go to the doctor monthly in the beginning of July, August, September, October, November, and I have an appt. Dec.3rd. That is 6 months.  I have an appt. with the Bariatric clearance guy in the hospital Nov. 7th and then I meet with my surgeon on Dec. 4th for my date and to send everything out to insurance.  Now here is the big problem:  The receptionist at my doctor’s office has had WLS herself and is like the coordinator for WLS there.  She says since my appt. with the Bariatric clearance doctor is Nov. 7th that she can push up my appt. with the surgeon for sooner.  But how can I get an appt. sooner if my 6 month appt. with my PCP is Dec. 3rd?  I think she is trying to ru**** and she says they deal with this all of the time and that it will be fine.  By the time they send out everything to insurance I will have had the 6 month diet.  What does everyone think of this?  Did anyone else’s surgeon’s office seem to be in a rush to get you in sooner?  I know it is a nice gesture but I do not want to be denied.  

 

 

p.s….this is  a very good surgeon and the girl is wonderful so I am not bad mouthing in any way just a little worried that maybe they do not deal with Cigna too much?  I don’t know, just nervous is all.

 

 -Lili 


 

Rahsheeda80
on 11/1/07 6:47 am - Greensboro, NC
Wow, I think we are along on the same exact plan.. I started talking to my PCP in March and then actually started my supervised diet beginning of July and have my last appointment on Dec 3rd as well... But unlike you, my Bariatric coordinator wont schedule my pre op surgeon visit  until after that last PCP visit.. I wish they would try and bump me up, but everyones program and surgeon are different... If they can get you in sooner I would take that, especially since you will have still completed your last visit by the time they submit for insurance. Rahsheeda



Highest 268/ Current 160/ Dr. Goal 130/ My Goal 125/ Height 4'11"Photobucket

fat-G
on 11/1/07 9:01 am, edited 11/1/07 9:14 am - TN

I have Cigna and got approval for the RNY promptly with a sketchy 6 months weight loss documentation ( some of my PCP visits spread between 5-6 weeks), But I believe the quick yes was mostly due to my high BMI . I’m now trying to get approval for Duodenal Switch WLS. (Not so easy.)

 I feel you can start knocking out some of the grunt work simultaneous with your last few weeks of the 6 months period without any problems but agree you need to stay proactive with every detail because nobody will care about your success like you do.

P.S. One tip I also would give is to write a very personal letter why you need/would benefit from WLS.  Wishing you  the best of health.

 

     Highest weight          Date of Surgery        Last weight in
          489 lbs                         459 lbs                     374 lbs

 

                         G Man  

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