Recent Posts

lovemyhorse
on 11/7/13 2:48 pm
Topic: HELP!! Need Dallas dr. and insurance specialist help. Got 2nd denial from cigna

I have had a lapband for 10+ years. I have never had any luck with losing any weight with it and the past 3 years it has been very painful due to scar tissue building around it. I have 3 years of visiting my Primary care dr with stomach pain, chest pain, and reflux. Spent thousands on tests and office visits + EGD and barium swallows trying to figure out why the band hurts so bad. No slip, no erosion, just hurts like a madman. I now weigh exactly what I did when I got the band with a BMI of 35. I have insulin resistance (but not diabetes yet) high blood pressure, reflux, sleep disorders, hypo thyroid issues, serious depression, shortness of breath, and very high triglycerides. All of these conditions require 7 expensive meds a day plus therapy and counseling for the depression. My primary care dr. has written letters to CIGNA practically begging them to revise from band to sleeve. My surgeon, who put the original band in, has asked for the okay to revise. Yesterday Cigna reaffirmed their decision to deny based on (are you ready for this) #1 There has been no evidence that there has been a mechanical failure of the band and #2 Weight loss surgery is experimental for the treatment of diabetes. I DONT HAVE DIABETES AND THE DR NEVER SAID THE BAND HAD A MECHANICAL FAILURE. I only have until the end of the year and then my husbands insurance changes to where we will no longer have WLS coverage. At this point I would love advice and recommendations for which Dallas area doctors can get fast new patient appointments and most important who has the best, most experienced insurance approval staff? I am so frustrated with this. Badly need help very soon.

BelieveInFaith
on 11/7/13 10:08 am - NJ
RNY on 08/08/13
Topic: RE: Just got approved.

CONGRATS!!!

Never accept NO for an answer.

 

        
LML8789
on 11/7/13 4:55 am
Topic: RE: Just got approved.

Congratulations!!!!!  We're both November sleevers!  I just found out yesterday I was approved as well--11/20th is surgery date but had to start pre-op diet already.  Good luck on your surgery, 

 

Lisa

 

                  

        
hollykim
on 11/6/13 9:46 am - Nashville, TN
Revision on 03/18/15
Topic: RE: Anyone file for/receive SSDI for co-morbidities?
On November 5, 2013 at 6:27 AM Pacific Time, CiCiBaby wrote:
Thank you everyone for your positive and informative responses. My life is better for having heard your opinions. And thank you for working hard so I don't have to. Much appreciated!
You asked for our Opinions when you posted on a public forum.
Too bad it was not what you wanted to hear.
However,our lives are NOT better since you are trying to milk the system.

Only sorry ppl do that.

 


          

 

PNGmom
on 11/6/13 4:40 am - Port Neches, TX
Topic: RE: Insurance question
Just got approved. ABath your next. Let me know.
PNGmom
on 11/6/13 4:39 am - Port Neches, TX
Topic: Just got approved.
I just heard from surgeon office. Just got approved for sleeve surgery.
I am so excited. I will start my pre op diet on the 19 th of Nov, and
Surgery will be on the 25th of Nov. Yeah me!
illinois Gama D.
on 11/5/13 1:38 am
Topic: RE: Anyone file for/receive SSDI for co-morbidities?

WOW, ALL I CAN SAY IS WOW, I am amazed   and saddened but the response, I hav e worked hard all my life for me, for my family, for my health insurance, NOT FOR YOU.

Rny 2003

come join the new R&R 3.0, where the fun is:)

 

 

 

 

 

 

 

 

 

 

 

CiCiBaby
on 11/4/13 11:00 pm
Topic: RE: Anyone file for/receive SSDI for co-morbidities?

The word I used was "dedicate", not "concentrate".

CiCiBaby
on 11/4/13 10:27 pm
Topic: RE: Anyone file for/receive SSDI for co-morbidities?
Thank you everyone for your positive and informative responses. My life is better for having heard your opinions. And thank you for working hard so I don't have to. Much appreciated!
illinois Gama D.
on 11/4/13 12:14 pm
Topic: RE: Anyone file for/receive SSDI for co-morbidities?

you cant find the info because the answer is NO, I agree with the other poster, we all started with the same issues, we did it fine, with little time off  work and certainly did not have to leach the system to get time off and paid for that we ALL  pay for one way or another, I this some  of us are taking offense that we would be supporting you while you figure out your way around your surgery! YOu are working a job now and doing ok, I am sure you will do fine after your surgery, the recovery is not usually more that a few weeks,,,,, use medical time, vacation days, personal days, don't have the public pay for your free time off!!!!

Rny 2003

come join the new R&R 3.0, where the fun is:)

 

 

 

 

 

 

 

 

 

 

 

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