wrong procedure approved???????

doodlebugjr
on 5/29/11 12:23 am
I am not sure if this is common?  My surgeons office submitted my surgery request to Cigna on May 11th,  I was aprroved on May 25th.  YAY right? Well the procedure that was approed was the lap band!  I want to have the VSG!!!  My patient coordinator says that she will have to submit a change of code!!  WTH?  I am scared that Cigna will now decline!  Has anyone had this happen before?  Is it just as easy as changing a code????   ........................
Kim_M
on 5/29/11 12:25 am - LaPorte, TX
They approved me for Ryn .I told them I had asked for sleeve no big deal apporved in a couple of days.My surgeon favored Ryn uptil the moment I went in I double checked with him sleeve here.Don't worry
                                                                                                                                                           
  First month since VSG 33  2nd 14 lbs 3rd12lbs 4th10lbs 5th10lbs 6th 9lbs 7th 13lbs 8th 13 lbs  9th 2 10th 6 11th bounced 175-180 12th  bounced  13th 2 lb cw(164)      
MsHarriet
on 5/29/11 9:15 am - Albany, NY
Hi Kim,

I received my date of 7/7 this past Wednesday.  Up until then I had my mind made up to have RYN.  When I met with the surgeon he has suggested the sleeve.  I am 57 and weigh 307 now and my goal is 150.I have heard that the weight comes off slower.  Any thoughts to help me make my mind up on the surgery i should go with would be appreciated.  Thanks in advance.
Surgery 7/7/11 HW 330  GW 175       
Kim_M
on 5/29/11 11:16 am - LaPorte, TX
I am 5 8 and love my sleeve !!i weighed 303 then was so nervouse gained to 318 but was back down at time of surgery!!!I wouldn't have it any other way .THe things that are diff for me is I drink no problem and eat faster thatn i should but still a min. amount compared to before.Not advocating it but I eat what ever i want and my loss is great!!!I can't really say anything but I luv it!!!I din't want the malabsorbtion  problems and this is the only way I would have gone!!!!
                                                                                                                                                           
  First month since VSG 33  2nd 14 lbs 3rd12lbs 4th10lbs 5th10lbs 6th 9lbs 7th 13lbs 8th 13 lbs  9th 2 10th 6 11th bounced 175-180 12th  bounced  13th 2 lb cw(164)      
MsHarriet
on 5/29/11 2:34 pm - Albany, NY
Thanks for responding!  I am excited and thsi has help me to make the decision to go with the sleeve.
Surgery 7/7/11 HW 330  GW 175       
Charb35
on 5/29/11 12:47 am - OH
It depends on your insurance. If Cigna allows for the sleeve it will take a couple days, if they don't you might have to put in an appeal. Cigna is pretty good though so you shouldn't have anything to worry about. Good Luck.
Mommy2Girls
on 5/29/11 1:16 am
Hubby's sleeve was first approved as a band...WHAT??? Thank goodness we figured it out...it did delay his surgery but there were more factors than just the approval (surgeon was on vacation and the day he was approved happened to be the surgeon's last day for surgery for 2010 so we had to pu**** out in to 2011.) But yes, the surgeon's office made a mistake and had to resubmit for the sleeve. The sleeve is covered through our insurance so that was never an issue.

Ideally he wanted the sleeve in 2010 because it would have saved us $5K but in the end he still wanted the sleeve and we shelled out the additional $5K.

Good luck, I hope they get it all straightened out for you asap!
-8lbs lost during the 6 month insurance hoop jumping,
the rest is since surgery.

Daviegrandma
on 5/29/11 1:54 am - Davie, FL
I have Cigna too. I am still in the process of my 6 month supervised weight lose. I am getting ready by seeing the cardiologist, nut, psych and labs. How long did it take you for your aopproval and what paperwork did you have to submit?
                
doodlebugjr
on 5/29/11 3:13 am
I had to submit 6 month diet records, letter from pcp stating necesity, I did meet with suregeon, psch eval, and dietician prior to submitting to insurance!  Anything you can send the better!!!!!!  Previous diets, other Dr letters stating that you would benefit from VSG...  etc!
Erica77
on 5/29/11 2:22 am - MN
I have Cigna and the same thing happened to me. I waited a week for the first approval which was the mistake, a lap band. I waited another week for the right surgery, an RNY. I now have my date for my sleeve. A girl can change her mind right?
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