day 8 ...still no insurance approval
damn CIGNA. this is killing me, the waiting, anticipating. I just want to DO this! and so, I will call back on Monday, for my daily call to pre-authorization (boy, they sure do have an unfriendly bunch working that department) *sigh* wish me luck for Monday!
I learned that the medical director at my clinic had been sitting on my file for an entire month - had not sent out the request for pre-authorization to the insurance (I was pissed)....after calling (damn near daily) come to find out, he didn't think I would qualify b/c my BMI was lower than 40 and I had no co-morbidities.....however, I finally asked the nurse were they looking at the current version of my insurance company's pre-auth criteria --- only to find out that the Medical director had been judging his decision based on 2009 insurance info-- (current criteria for my insurance was updated 6/2012).....ugh! With a huge apology that I rec'd from the clinic, they submitted the insurance pre-auth on 11/8/12 to my insurance company and I was approved within 24 hours 11/9/12!! I am so loving the outcome...will be connecting with the nurse Monday to establish a surgery date for early or mid December.
My file was submitted to my insurer on 10/23/12, after I finally finished the two additional months of time the insurer insisted I spend having three separate nutrition consults 30 days apart. (All of my other presurgical testing and consulting was done.) No one heard anything, so my doctor's office called the insurer this past Thursday. Nothing.
I called them myself yesterday and initially was told that they had nothing on file for me! The doctor's liaison was about to explode when she heard that! Called AGAIN yesterday and miraculously was connected to the very nurse who was reviewing my file in preservice. She apologized for the delay, saying that she had had to push my file and others aside to review emergency cases and also saying that her office had been closed for five days due to the superstorm we had here in the East around Halloween.
She finally got to my file, and my approval came through yesterday, twelve days before surgery. I've read about closer calls than that in these boards.