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Surgeon Testimonial

William Johnson
GREAT young Dr. that is a pleaseure to talk to and he kept it real at all times. I appreciated the fact that he didn't sugar coat anything when speaking with me. I've only met him once so far, but first impression are what matters the most. The office staff is very pleasant and helpful. If you are considering Dr. Johnson and his staff know that they are very detailed oriented and will make sure all the I's are dotted and the T's are crossed before submitting to your insurance. The y stress that you attend support group meetings before and after surgery. rnrnWill update later about his surgical competence & bedside manner.
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  • Comment by Irishcoda on 4/9/09 12:50 pm
    Hi, I saw that you're having surgery today and just wanted to wish you well for a smooth procedure and a very speedy recovery! :)
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firstloveee2000's Blog
firstloveee2000's Blog


WEIGHT MANAGEMENT PROGRAM
on August 14, 2008 10:51 am
I have scheduled my first appointment to get the weight management program started so I can knock out these six months by Jan./Feb/ 09. Will let you guys know how things are going keep me in your prayers because this is one sista that don't have much patience for having to start all over when I was just soooo close.

My first appointment is scheduled Sept. 2, 2008. My PCP better get every detail right in my medical file this time around (weight, diet & exercise notes) and don't be waisting my time if he's not going to be detailed as required by the insurance co.

Continue to pray for me as I will for you.

~Chasz~
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DENIED!!!!!!!
on August 14, 2008 10:27 am
I was informed yesterday that I was DENIED!!!!! for the following reason:

 After reviewing the notations documented by the medical director, it appears the pre-determination was denied  because medical necessity for bariatric surgery has not been established due to:
 
- complete documentation of a 6-month physician-supervised weight management program in the past 2 years without significant gaps as delineated above has not been received
 
- complete documentation of a 6-month physician-supervised weight management program in the past 5 years without significant gaps as delineated above for long-standing morbid obesity has not been received
 
- programs such as Weight Watchers, Jenny Craig, and Optifast are acceptable alternatives only if done in conjunction with physician supervision and detailed documentation of participation is available for review
 
- physician-supervised programs consisting exclusively of pharmacological management do not meet this requirement of a physician-supervised weight management program.

Now here's a paragraph from Cigna's guidelines:

for individuals with long-standing, morbid obesity, participation in a
program within the last five years is sufficient if resonable attendance in the weight management program over an extended period of time of at least six months can be demostrated.

I GAVE THEM 1 & 1/2 YEARS OF WEIGHT WATCHERS INFORMATION FROM WHEN I ATTEND THE MEETINGS (Weekly weigh-in's etc.) AND MY MEDICAL FILE NOTED MY PARTICIPATION IN THE PROGRAM IN BOTH 2005 & 2006.

So they are telling me because I did not go to the Dr. for six consecutive months they have denied me, this is some BULL$%@#!!!!!!!!

Well I guess my journey begins all over.  I just hate that I may have to take that Upper GI test again.  That's the worst thing I have ever been through in my life. I will keep you posted on my progress.

~MUCH LOVE OH FAMILY AND KEEP GOD FIRST~




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Still Waiting Part 3
on August 12, 2008 7:17 am

As of today I have been informed by my contact at Cigna of the following:

The review group gave me an update that this is currently being reviewed by the medical director, which is the final step.  Hopefully, we'll have a decision by tomorrow.

YEAH BOY!!!!!!!! Keep your fingers crossed. Hopefully this week you will see those famous words of I'M APPROVED!!!!!!!!! Keep GOD first. Until next time my OH family.

~Smooches~ Your Girl Chasz

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Still Waiting Part 2
on August 6, 2008 11:51 am
Well since my last post I have still not heard anything from the insurance company whether or not I'm approved. I was informed by my place of employment that our Insurance coverage starts all over on October 1st. This was not good news for me seeing that I have already met my deductible this year.  (And as you may know they are raising the insurance deductibles and the maximum out of pocket expenses, and I have to pay out not only the 3% raise I got but even more of my income which is some BULL@#*%) I had to think of a plan and fast, because I need to have this done before the new calendar year starts.  So I have called my benefits contact and she provided me with a contact directly at Cigna. 

Well I have spoken to the contact several times and have been misinformed. I was told that they did not receive all of my paperwork on the first two occasions.  When I arrived to work this morning I had yet another e-mail saying she was misinformed and they do in fact have all of the paperwork required.  She also stated that she has asked them to escalate the process for this is a time sensitive case, and asked that I give  them at least another week to review my case/file. One more week is not going to hurt but time is of essence.

So once again I ask you all to keep me in your prayers. Until next time my OH friends.
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