Nonny S.

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I saw my PCP today.  She ran some blood work to check my cholesterol and after she reviewed my chart and the Cigna info I brought her, she recommended I start my 6 month diet over so that she could document more to give us a better chance to get this approved. I lit a cigarette and called my mom as I was driving out the parking lot so upset, but she helped me realize that I would probably need that time to save up for my co-pay anyway.  It's still just so frustrating.  I am so glad everyone in my family and the few friends at work I have told are very supportive.  My brother (he's only 18) came over last night and asked how my surgery progress is going.  I didn't realize that in the mist of all the chaos I never told him that I changed my mind from Lap-Band to RNY.  His eyes filled up with tears and he just said "I don't think I will be ok with this".  I told him earlier that I was going to a seminar next week and he asked if he could go with me and mom.  I told him that I didn't want him to take off of work early for me and he said "No, it would be for me.  I want to meet your doctor and listen to what exactly he will be doing."  Then before he left he hugged me twice and the last time I thought he would never let go.  When he left I just kept thinking about how lucky I am to have people in my life who love me so much.

I got a call back from the psychologist (Dr. James Harrison in Sherman).  His secretary told me that she notified Cigna and they told her that I would only have a $40 copay to get the evaluation.  I explained what they told me yesterday and she said that sometimes they have an individual contact who knows more than the rep whom the patients get when they call direct.  I'm trusting her and made an appointment for the 10th at 9:30-12:00.  Great...another half day of work I need to miss.  But it will all be worth it.  Thank goodness I get 4 personal days and 2 weeks vacation paid for this year.  But my boss is  gonna freak when I schedule off for 2 weeks in a row (at least) for the surgery.  He's pretty supportive, but you just never know sometimes.

I'm now trying to get an appt. with a psychologist so I can go ahead
and get my evaluation and letter done before my consultation.  I called
Cigna's Behavioral Health Center and they said that I would have to go
through the regular medical portion of my insurance since it is for a
medical procedure.  The regular medical side of my insurance says that it would be covered under the BHC.  I got ahold of a girl named Jill on the medical side (bless her heart) she put me on hold twice while she double checked with a co-worker and then her boss.  She then said that they would only cover the evaluation if my surgery is approved but they would not approve the surgery until I had an evaluation.  I thought, ok, I will just pay it out of pocket...the quotes I got were anywhere from $250 to $1500.  I called Jill back and she said that if the psychologist submits the claim as a requirement for bariatric surgery, then it would have to go through medical, but if he submits it for just a regular evaluation then it could go trough BHC and it would be covered 100%.  So I think I will try that.  I need to save all the money I can just for the copay for the surgery itself ($3500).

*morning*
Ok I called them again today.  (Can you say OCD?)  I talked to Heather
at my company's benefits center and she said that my company has no exclusions on the bariatric surgery procedures.  I'm getting too obsessed with this whole process.  I need to get my mind on something else.  Really, I need a cheesecake and a cigarette (haha), but I'm still holding myself back.
*afternoon*
Well, I got a call from Dr. Thrift's insurance office and they tell me
that he is no longer a preferred provider on my insurance.  He was last year when I made the appt. but not now.  So I have a seminar scheduled on the 8th with a new doctor in Plano, Dr. Cribbins.  He has alot of good testimonials on ObesityHelp.com and alot of those testimonials were from those who had Cigna, so at least his office has gotten approvals (which says alot).  I am still keeping my appt with my primary doctor so that I can have everything I need (I hope) by the time I have my new consultation.  Gees, by the time I actually have the surgery I will be a pro regarding this procedure!!!!

*morning*
I just changed my name on this site.  I heard a rumor that Cigna searches these sites for any info to deny a claim.  I'm sure it's not true
and I feel a bit paranoid, but I'm not taking any chances.  I will change
it back to my real name once I have had the surgery (when that day ever gets here!!!).  I just cannot wait to talk to someone about the
insurance.  I called a woman by the name of Jan at my company's Benefits Center asking about that Weight Support System and she told me to just call Cigna direct.  There I talked to Sylvia or Shirley (?) and she told me to just go online. (duh!!)  I told her I needed an updated version because the date on that info said it was revised on 5/15/2005.  She said she couldn't help me.  What the heck are they there for?  I guess I'm getting a little too anxious.  I did go ahead and make an appointment (this Friday at 11:30) with my primary doctor to get all the tests done that Dr. Thrift wrote down (you gotta love that man!!!) and her recommendation letter.  I'm also going to have her recommend a psycologist for me to see to get an evaluation with.  I also had my last cigarette last night.  I don't know if it was such a good idea to quit while I'm going through all the stress of this insurance s**t, but I'm going to keep it up just in case. 
*afternoon*
I just talked with Joe at Cigna Benefits department and he said that he
hasn't heard of any changes for the Bariatric Coverage for this year. 
So maybe...just maybe...Dorothy from my company's benefits department was mis-informed and I won't have to be on that stupid program for a year.  Joe did tell me that they would only hear of something about a day or two before the change is applied so it still could happen.  Hopefully if I can get this next application in before the change happens, I will be a part of a "grandfather clause" if they even would consider that.  With the way my luck has been going on this, I doubt it.  Oh and by the way...I need a cig...like jittery need one. Yeah, it's not fun.  I keep telling my self "Do you want to be thin, or do you want to smoke?"  So far it's working.

Today was my consultation with a new surgeon, Dr. Thrift at a new facility, Barix Clinics in Wylie, TX.  It was a completely different experience from the other consultations I have had in the past.  I met with a Coordinator first who explained to me the facility and my BMI and what my weight should be, etc.  120!!!!!  Wow!!!!  I just don't see me ever being that small.  I think the last time I was 120, I was 12!!!!  I then met with the surgeon, Dr. Thrift and he explained everything in detail and gave me the pros and cons of both the RNY and the lap band.  He also drew diagrams and answered every question I had no matter how stupid they were.  We talked for about an hour!!!!  And let me tell you, I was very skeptical about having men be my doctor...for anything.  No matter how ugly they are, they just seem to look at me (being fat) like they are disgusted.  Not the case with Dr. Thrift!!!  He gave me eye contact, talked to me on my level and even shook my hand afterwards.  I then got to talk with a Patient Counselor by the name of Tiffany Chandler.  She not only works for the clinic, but Dr. Thrift did her RNY 16 months ago.  She brought in a photo album of her journey and the very first picture just floored me.  It was me!!!!  Except for the blonde hair!  We had the same body shape, everything.  Even our sons look alike!  Now she is gorgeous!!!  She explained everything she was scared about before surgery (all my fears) and gave me the low down of the good and bad post-op.  She even showed me her scar and excess skin.  She also explained the insurance part of it and explained EVERYTHING they would ask for to approve me.  No more surprises!!!!!!!  Unfortunately their insurance department is located in Wisconsin so I don't know what the status is yet.  But I should be getting a call from them next week to talk to me.  I've learned my lesson not to get my hopes up on my f-ing insurance until I hear it from the horse's mouth so to speak!  I will just scream if they say I still need to go through that "Weight Support System" for a year!  All they do is call me once a month and ask what I'm eating and what exercise I'm doing and how much I weigh.  My doctor does that!!!!  So, everyone cross your fingers and wish me luck on getting approved.