Att: SHBP Cigna Members!!!!!!!!!!!!!!!!!!!!!!!!!!!

LaShelle2
on 2/19/09 11:28 pm - STOCKBRIDGE, GA
Well, I already did the Health Assessment, so I have that base covered.
As far as the coaching program, I was told you have to do the online one which takes up to 12 weeks.

As a precaution I also signed myself up for the phone coaching. I had my first session last night. WHAT A WASTE OF TIME!!! The lady that called me had no knowledge of weight loss surgery. She said she was not aware they were making the coaching a pre-requisite to the wls. I asked her how the coaching would benefit me in the process and she did not know.

To make matters worse, she is very anti wls!!! She said she thinks you can maintain a healthy weight through diet and exercise, and the wls is too risky. 

I asked her about her weight history. She said she once struggled with her weight and got up to a massive 200 lbs!!!   OMG! I would love to be 200 lbs, and she was devastated she gained up to 200! She obviously had no clue what it feels like to be 320 lbs.  I was a bit offended by her attitude. I felt she was insensitive to the super obese.

At any rate, I will play Cigna's game and complete the online coaching, phone coaching, and health assessment, and anything else they want to throw in the pot.

They are gonna be tired of us shbp people.   I bet they cancel the wls coverage next year because too many of us are having it, and it will cost the state too much money.   Anybody on the fence about having the wls needs to get it now while you can!

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

talksoupslp
on 2/20/09 12:37 am

Of course the person didn't have a knowledge of WLS.  This program isn't specifically for WLS patients.  It is for ANYONE who has Cigna insurance through their employer.  It is to promote lifestyle changes.  And it has nothing to do with Cigna's WLS policy, so again, why would she know it was a pre-req to WLS.  It IS an SHBP policy to go through the coaching program.  In fact, post-WLS, we wouldn't qualify to take advantage of this program.

As far as benefit?  Anything that can help you to start thinking differently and put you in a different mindset is a benefit.  As you get into the coaching, they will talk about setting short term goals, eating according to the food pyramid, how dedicated you are to making lifestyle changes, whether or not you have confidence in yourself to make the changes, etc.  Remember, WLS is a TOOL not the quick/easy fix.  So, that stuff is important.

As far as your coach being anti-WLS, maybe you need to discuss that with her.  I don't know if you can request a different coach.  My coach has been great.



Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
tchrmom
on 2/20/09 1:28 am - Northeast, GA
I hope I didn't get your coach!  Mine is Rebecca and is going to call me on Monday.
LaShelle2
on 2/20/09 5:55 am - STOCKBRIDGE, GA
Nope, mine is Lumi.  She wasn't outwardly rude. I don't think she was even aware that some of her comments would be hurtful to an obese person. She just sounded kinda young and clueless.

As far as the requirement to do the coaching thing Talksoup. I don't have a problem with it. I am 100% sure it won't change my decision to have wls, and I won't lose anymore weight with it than without.  So, if that's Cigna's goal, they need to try a different approach.

I agree for the average person, it is important to follow the food pyramid, etc., but as a post-op you really wouldn't follow the pyramid anyway. Since, you would require more protein, smaller portion sizes, and less carbs, any nutritional advice the coach gives will probably be useless after my surgery.

I will try to act like Polyanna and find some good out of this experience.  At least it's free, and you don't have to take time off work or travel for the sessions. Mine are 8;00 pm on Fridays.

I do think Cigna SHBP need to make up their minds what we need to do and stick to it, or at least have some kind of system to notify you of any changes if you are in process of getting approval.

What if you were not a member of this board? How would you know they even changed anything?

I will be one pissed off sista if I get to the end of my 6 mos diet and they add another bogus requirement!


               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

tchrmom
on 2/20/09 7:51 am - Northeast, GA
Those were my thoughts exactly when I heard about the food pyramid! Too carb heavy! No use to us WLS people!

I agree, whatever it takes, I will do it, but they do need to settle it and quit changing the rules.

I have actually done my 6 months with my pcp, I am meeting next week with the surgeon, and it is ticking me off that I may now have to wait 3 more months to complete a coaching program.  They told me 3-12 weeks, so I am wondering what you have to do/say to get the 3 weeks instead of 12!

LaShelle2
on 2/20/09 8:31 am - STOCKBRIDGE, GA
Lumi told me all I have to do is ask to be graduated. Not sure how true this is. I hope you don't have to wait 12 weeks!!!! That would be a shame.  That's so not fair for you to have come this far and have everything possibly held up by this.  Hopefully the will make an exception for you.


I guess you will be the first shbp member to get her wls, since everybody else is still on the diet.. That officially makes you our guinea pig.  Please keep us posted on everything, so we will know what to expect.

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

talksoupslp
on 2/20/09 8:47 am
>What if you were not a member of this board? How would you know >they even changed anything?

You would find out when they denied you, like I did.



Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
LaShelle2
on 2/20/09 8:49 am - STOCKBRIDGE, GA
I didn't realize you had already been denied. When did that happen? What was the reason for denial? Was this with Cigna SHBP?

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

talksoupslp
on 2/20/09 8:52 am
Yes, it was with Cigna SHBP.  about 2 or 3 weeks ago.  And main reason for denial was not having done the coaching.  They also didn't have my psych (which WAS faxed to them, so they must have misplaced it) and while their documentation states 6 monthly visits with your PCP "without significant gaps", 2 months missed is considered a significant gap (that after being told it would be fine by Cigna).


Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
LaShelle2
on 2/20/09 9:39 am - STOCKBRIDGE, GA
I am so sorry that happened. Now what do you have to do?

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

Most Active
×