Could I be Denied because I already have approval?

MSSEXXC74
on 8/23/13 2:27 pm

I was just thinking is there anything i should do about letting CIGNA know i don't plan on having the sleeve i was approved for with a different doctor? OMG could they deny because i already have an approval with a different doctor for a different surgery. Do i need to call them? 

MsBatt
on 8/23/13 10:23 pm

So what ARE you planning on having? Generally you can transfer your approval to a different surgeon.

Ladytazz
on 8/24/13 12:33 am

You would think they know what their own company has approved but you never know but, yes, I would contact them and ask about having the approval switched to the new doctor and surgery or you may find yourself without any surgery.

Whatever you do make sure you document every contact you have with them including who you have talked to, what department and extension number.  It is not uncommon to talk to one person who has no clue what is going on, spend hours working things out only to find yourself with someone else the next time who has no clue.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

Whit
on 8/24/13 7:25 am
Revision on 12/10/12

Hi ,I know you re now having Dr. Keshishian revise to DS. Unless things have changed since last year his office confirmed coverage and got the ball rolling. I only called to inquire about specific coverage and if he was an approved Dr. before I made consultation appointment. Then I flew down to see him before insurance was even confirmed. I wanted to meet him first. His office called me to notify me surgery was approved and schedule surgery. 

Good Luck

Whit

Revision from RNY to DS 12/10/12 Dr. Ara Kesishian BMI: 19

Created by MyFitnessPal - Nutrition Facts For Foods

 

 

 

          

MSSEXXC74
on 8/24/13 7:32 am

I  know they are going to submit for surgery but my concern is they may deny it and say it is a duplicate authorization. Dr juarez has an approval for me to get the sleeve. I know that i was having a MRI and changed locations so the new place sent a request for authorization and they denied it saying it is a duplicate charge.

Lisa O.
on 8/26/13 1:26 am - Snoqualmie, WA

I would think that Dr. K's insurance specialist could get it all straightened out but you'll need to be clear with your concerns and what you're worried about.  You're lucky he has an insurance specialist!  They speak the same language as the crazy insurance companies and know what to submit.

Hopefully they will help you.  If you already had the heart test could they use those results?

Best of luck!

Lisa O.

Lap Band surgery Nov. 2008, SW 335. Lost 116 lbs.  LB removal May 2013 gained 53 lbs. Revisied to RNY October 14, 2013, new SW 275.

    

    

MSSEXXC74
on 8/26/13 4:57 am

OK Kristina from Dr. Keshishian  office just emailed me back. She said that they are going to submit for approval for the DS surgery. She said that I do not need to call the insurance company and tell them anything. She said once they submit to the insurance company then the insurance company will know what is going on. She said that as long as I didn't go ahead and have the surgery I should be fine.  She said should they contact her and say that I need to cancel the request for the sleeve surgery that she will let me know.

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