Recent Posts
Topic: RE: From excited to total frustration!!
Tallgrass in Topeka does lapband, I am meeting with a surgeon on June 12th, this is just my first step. I don't know about your insurance so I am not sure if they are in your network. I am hoping that I don't have to do a 6 months supervised diet, (like that has ever helped) I will only put on more weight.
Topic: CIGNA had to PAY!!
Finally a little bit of good news! Cigna had to pay for my gallbladder ultrasound! When i started this journey, Cigna's website and member service's personel told me that ViaChristi in Wichita was an in-network hospital. This was good news since ViaChristi is the only hospital in Wichita that will be doing the lapband!
A month or so ago, I went to ViaChristi for the required gallbladder ultrasound. On May 16th, all my paperwork for surgery was turned into Cigna for approval. I've been approved for surgery, but Cigna was now saying that ViaChristi is out of network. When checking my claims on the website, sure enough, I found that they hadn't paid a dime for the ultrasound....claiming out of network.
To make a long story short, I raised hell. I talked to a dozen or so people from Cigna, all of whom verified info that ViaChristi was in-network. I made copies of the website page that showed their listings of providers. I documented the conversations, names, date, times.....and let them know at the end of the conversations that I wanted them documented and on the record for future reference. I called and complained to our employer's benefits specialist. I filed a complaint with the Kansas Insurance Commission.
I tried to access Cigna's website the last couple of days. It was down for maintenance. Finally today, I was able to get on. To my surprise, the claim for the ultra sound now is showing paid at in-network benefits!!! I also received a phone call this afternoon from our employer's benefit specialist....verifying the same thing. I received a letter in the mail from the Insurance Commission verifiying an inquiry to Cigna on the complaint.
Well....after the website update, Cigna is no longer showing ViaChristi as a participating provider. And as far as getting my surgery done at ViaChristi...it's a no go because the information has all been corrected PRIOR to my surgery. I am now going to have my lapband done at LivLite in Junction City.
At least Cigna had to fork over the benefits for the ultrasound! Chalk one up for the little guys! Several hundred dollars may not be a big deal for the insurance sharks....but for me, it's a very big deal!!!!
Topic: RE: What is u*****T in Kansas?
Monique - Sorry you had to go through the open surgery. I know from experience that is a long and more painful recovery. I am glad to hear that you have done so well as there are a few bad stories about Mexico along with many sucesses. You are lucky to find someone to do your fills so close. Did you go to the Good Ole Days in Ft Scott? We didn't but for years when my daughter was young we went, she just loved the children's fair.
I think when you start getting some fills you will find you sweet spot and things will really start to progress.
Keep me posted on how you are doing. BTW, are you interested in a support group in the area? Let me know.
Kat
Topic: RE: What is u*****T in Kansas?
My only complaint was that they could not do it laprascopic once they got started due to my abdominal myo not relaxing, so I had to have the full blown open me up surgery. The mend time is a little longer and slower. I have an appointment for a fill in Topeka with a doctors that does fills for Mexico patients. I hope I can go back to work next week, but I still have two open places open that are draining fluids. I have lost a little, but don't have much restriction. I'm sure I will see a big difference after my first fill at the end of the month. Monique
Topic: RE: What is u*****T in Kansas?
Hi there! It is great to hear from somewhere so close by! Wow, TJ, I would love to hear about your experience there. I hope you are doing well. Is it hard to get your fills done in the states? I had my surgery done in KU so I travel back and forth for follow ups but that is fantastic for me as I love any excuse to go there and stop and shop on the way home. PM me when you can I would love to hear more. Kat
Topic: RE: What is u*****T in Kansas?
Hey I notice you are from Frontenac. I live just North of Ft Scott. I had lapband about 3 weeks ago in TJ Mexico. I'm all for help and support.
Topic: RE: just starting this roller coaster ride!
If you don't mind me asking...what insurance do you have? Alot of them require a 6 month or better medically supervised diet before they will even consider approval. I found this to be true with my insurance when I started my journey. At first it was discouraging, just the thought of having to wait six months....but the time goes by faster than you would think. Actually when it was all said and done, I was grateful to have the time. It seemed as though there were so many appointments, etc. to take care of during that six months.
I'm not trying to give medical advice here, but be careful that your doctor isn't considering just the use of Phentermine as your weight loss program. I know for a fact that some insurances will not accept that alone as enough for approval. They want to know what type of diet, exercise, behavior modifications, etc., ALONG with prescriptions if used. I have a form that I took to my doctor every month, a progress note so to speak....that she filled out. When Kate Jantz saw these, she was very impressed with the information on it...even asked if she could have a copy of it. She stated that sometimes they have trouble with the doctors not giving enough information in their notes and then insurance denies because of this. With these progress notes from my doctor, along with all the info from solutions for life....I got approval for surgery within one week. Unfortunately for me, Via Christi is out of network. If you would like a copy of the form...simply email me privately and I would be happy to send it to you.
As for solutions for life....I think it's a good program, but I think they are cashing in on being the only providers in the area for bariatric surgery. Just do your homework. And watch out for the hidden costs.
Topic: RE: What is u*****T in Kansas?
Good luck on your upcoming surgery! I am glad to get a couple of responses. I can understand posting on the Missouri board as there are a lot of good and supportive people there everyday. I think I am going to see if they will adopt me. Keep us posted on how things go for you! Kat
Topic: RE: What is u*****T in Kansas?
Well I live in KS but I am having surgery in Missouri so I post there mostly.
I have my surgery June 18th.