Recent Posts

Lori F.
on 8/17/11 1:20 pm - Chula Vista, CA
Topic: RE: medicare medicaid plus pay aftercare self pay in cash preop?
There is a surgeon here in So Cal that has a 3-4000k program fee for aftercare. Research the program fee- you can read all about it. You can definitely find an RNY surgeon who does not charge the program fee, though.
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
Lori F.
on 8/17/11 1:16 pm - Chula Vista, CA
Topic: RE: Questions on Interpreting Insurance Policy Lingo (CIGNA)
Read your policy carefully. My CIGNA policy specificall excludes bariatric surgery UNLESS it is medically necessary. Read it with a magnifying glass. I also had to convice a doc's office that I do have coverage. Send the doc the paragraph that says bariatric surgery is excluded EXCEPT when medically necessary. I think Cigna hopes that we will just read the first part and give up.
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
Lori F.
on 8/17/11 1:08 pm - Chula Vista, CA
Topic: RE: CIGNA 6 month medical weight loss requirement
It is my understanding that you just cannot get out of this. And don't miss a month or you may have to start over. Start now and it goes by quickly! You have many other things to take care of before surgery too, so it all takes time. Good luck.
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
Nan2008
on 8/16/11 10:37 pm - Midland, MI
Topic: RE: approved - approved - approved!!!!!
Congratulations!!!!!   Getting that approval is one of the best parts of this whole process!!

Nan

HW 300
/ SW 280 / CW 138 /
GW 140
Hit Goal 4/2/2010

        
Ericha2
on 8/16/11 12:31 pm - CA
Topic: CIGNA 6 month medical weight loss requirement

I just got my first denial letter based on CIGNA needing additional information from my surgeon as well as a letter from at least one other physician stating that I need to have surgery.  They are also requiring the 6 month medically supervised weight loss program.  When I first contacted CIGNA back in April I asked them if Weigh****chers was sufficient and they said it would be, now they are saying it's not accepted, it has to be documented by a doctor.  What a waste of my time!

My question, has anyone ever been able to get CIGNA to waive that requirement?  Just in case, I am meeting with the nutritionist on Friday to start a program but I'm hoping that we can either lessen or waive the requirement. 

I have a BMI of 60, I have sleep apnea, high blood pressure, joint issues...I'm 35 years old and I've tried every weight loss program under the sun.  What more do they want?!?  Sorry, just frustrated right now.

I have my PCP and OB both writing letters and I'm going to write a letter as well as the Bariatric Nurse.  Hopefully we can make this happen but please let me know if you've had any experience or success getting this waived.

Thank you!

Erica

Angie H.
on 8/16/11 11:00 am - TN
Topic: approved - approved - approved!!!!!

Doing the happy insurance dance.....wooo hooooo........

  
    
Angie H.
on 8/15/11 5:26 am - TN
Topic: RE: Insurance Approval
I don't know... I have Aetna... I think they all get together and try to torture us!!! The wait is horrible...
  
    
Angie H.
on 8/15/11 5:15 am - TN
Topic: Aetna Driving Me CRAZY!!!!

I am so frusterated. I hate insurance companies. I hate insurance companies! And if ONE MORE person tells me to "just be patient" I am gonna scream! There is no way to "just be patient." Not when you are a passionate person giving something that you believe in everything you have. It REQUIRES you to be persistant, inquiring (nicely) on a very frequent basis.

Well, it would be different if I didn't keep getting the run-around from the insurance company saying that they don't have my stuff and that the proper procedure hasn't been followed! I KNOW that it has, and I know that they have it. Why don't they just say that it is in review? Wouldn't that be easier on all of us?!?!!? I guess after what happened before with the "other" doctor's office I have become a little gun shy. (With good reason!!)

I just hate that this is costing me more time. Changing doctor's/clinics was the best thing I have done since I decided to have this done, but it has cost me another month. Another month of aching knees and hips... Another month of all the other "junk" that comes from all this excess baggage. I am just so ready to move forward and begin. I want to start healing, getting better. Certainly no one can blame me for that....

  
    
tiz4tggr
on 8/15/11 4:28 am - TX
Topic: RE: Cigna 6 Month Weight Loss Documentation
Me and my PCP starting our monthly meetings back in May...but we didn't have any real way of documenting it other than writing notes in my file. We're going to use this form to document our monthly meetings.
carrierae
on 8/15/11 4:20 am - WA
Topic: RE: Cigna 6 Month Weight Loss Documentation
Awesome...but what is the 27 weeks? I have cigna and you are freaking me out!
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