Nonny S.

Send Message

Block

Add Friend

I went to my doctor's office to pick up the physical information.  She
had done it last night and it looked perfect (to me anyway).  As soon
as I got to work I faxed it to Sheryl.  I'm so excited!!  I will wait
until lunch time to call the insurance to check on it.  I don't like to
bother Sheryl since she is helping me so much.
*12:00 PM ~ I called Cigna Approvals and the automated system still
said that they had no request on file.  What the hell?  I then spoke with
Debbie.  I asked her if she could tell me if they received the
information they needed.  She said that she can't read the details of my account because a nurse was reviewing my case as we spoke (dejavu?) but that it was still listed as pending on further information from doctor.  Still Pending?  Does this mean it wasn't denied?  And you know I don't remember Sheryl actually using the word denied.  I thought that was because she didn't want me to freak out, but maybe I just did my usual "hope for the best, prepare for the worst" thing.  Anyway, she then said that once they make a decision they will send me a letter to let me know what it is.  Yeah, I'm not waiting for a stinking letter.  She said that they probably will call my doctor and he will call me.  Sorry lady, but I'm still gonna call you until I hear something.  I'm going to call Sheryl after 1:00 to make sure that she sent the info.  Then I will wait until just before I leave work to call Cigna again.  I hope I get Debbie...hahaha (evil laugh!)
*4:00 PM ~ Sheryl finally called me back and said that she did get the
fax and when she got my message, she called the nurse and asked if she got it and she said no (I'm glad I put a fire under her butt!) they
apparently staid on the phone with each other until the nurse received it.  She then told Sheryl that she would call her tomorrow morning with a determination.  AAAAAHHHHH  This is gonna be a fun night lol!  Hopefully my next post will be me saying I got approved!!!  Can you imagine?

*8:00 AM ~ I called my PCP's office to make sure that I can get a
physical today at my appointment.  The b!tch in scheduling told me that physicals with Dr. Schultze are being booked well into November.  WTF????  I am waiting until 9:00 to call Sheryl to see what she says.  Maybe I can get the nurse practicioner(sp?) to do it tomorrow or just go to the community hospital and do it there.  Hell, maybe I was hallucinating during our phone call and I don't need an official physical.  We'll see.
*12:30 PM ~ I went to see my doctor today about a boil that got
infected in my armpit. (sorry if this grosses you out, but I'm full of puss
and I can't help it lol)  I told her about what my insurance needed and
she said that she will "get me what I need" tomorrow when I see her when she tries to lance my "new friend" (gggrrrr).  She agrees with me that this requirement is ridiculous and she suspects that they just tried to find something...anything to deny me and to have me wait until November is like them having the last laugh so she won't make me.  Don't you just love her?  When I got back to work I had an email saying that Sheryl called while I was gone and the office won't be open until 1:00 so I will call her and tell her then.  I also am starting to feel like my boss is getting upset with all that I am taking off.  Hopefully after
tomorrow I will only be off one half day for my pre-op tests and then that will be it until I'm off for surgery.  I went ahead and told both of the
females at work (the rest are men) about my surgery.  One has known for awhile and is supportive, but thinks the LapBand is better and the
other one seems really excited for me.  She walks every day at lunch and told me to walk with her.  So I'm happy I have added support up here.

Yesterday I turned 30.  Blech!  On a postive note, I hope my 30's will
be better than my 20's.  This past decade suuuucked!  I met one of
mom's coworkers, Paula, yesterday.  She had a RNY about 4 1/2 years ago and is doing great!!  We instantly clicked and she helped settle my nerves alot.  Just meeting someone who is so excited for me did wonders for my emotions.  She gave me alot of tips and told me a bunch of stories about her experience.  I really enjoyed meeting her.
Status of Insurance approval: 
*9:15 AM ~ I called Cigna Approvals and the automated system said that they have not received anything.  I then requested to speak to an
associate and got Liz.  She said that she shows it is still being reviewed and listed as "Pending".  I can already tell that they are going to get sick of me calling.
*4:30 PM ~ I called Cigna Approvals and the system still said that they
have not received anything.  I held on until I spoke with associate
name Charlie (a woman).  She asked if it was regarding the surgery set up for Sept. 5th.  My heart jumped up into my throat and said that I never was told a date, so I didn't know.  She put me on hold for what seemed like forever and she finally came back on and said that it had been processed, but they are waiting on something from the doctor, but she couldn't decifer what it was they needed.  I almost called and left a message with Sheryl at Dr. Cribbins office and then thought that I needed more patience and to just give it time.  I did though call Cigna
Approvals again *smile* and this time talked with Debbie who told me that the nurse was reviewing my request as we spoke and maybe that meant that she got what she needed.  But she also said that the surgery was scheduled for September 5th, so they had plenty of time.  (I won't be able to have it then, because I need to give my boss one month notice)  No sooner had I hung up with her, Sheryl called (I swear she has ESP!!)  I was denied (Ahhhhhh).  She said that she has been arguing with the nurse for some time this afternoon because they are saying that we need one more thing.  I have to get a physical from my PCP.  Sheryl is ticked because this is not a requirement, but they are refusing to budge.  As luck would have it, I have an appointment for tomorrow morning at 10:45 and hopefully will be able to do it then (I can't make sure because the office is closed already).  She has to check eyes, ears, abdomen, etc and state that this is for "H & P for Bariatric Surgery" and that I am a good candidate for surgery.  I then can fax this to Sheryl and she said that the fax number she gave me is on her desk and she will send it over to the nurse asap.  She also said that the nurse stated how perfect my information was.  And that my doctor did a good job in documenting everything.  I will let her know that tomorrow.  Sheryl was afraid that I would be upset, but I don't mind.  To me, this is just a small hurdle.  Now if they said I needed it every month for the last 6 months, I would be p!ssed!!!

I feel somewhat better today.  Mom helped calm me about paying my
copay.  I'm leery, but it's better than popping Xanax every ten minutes!!  I also got conformation from a great lady on the message boards by the name of Julie Curbo that my gas problem from my CPap machine is probably due to me having a nose mask instead of a full face mask.  I called my sleep lab doctor and asked Tonya to request one through my insurance.  She said it should be submitted today.  Ok, according to the UPS tracking site, my paperwork got to Dr. Cribbins office at 9:44 this morning.  I was signed by P. Kretchmer (whoever that is).  I left Sheryl a message at 4:13, I just couldn't stand it anymore!!
~*Update*~
Sheryl just called me back at 4:30 and said that she got the paperwork
this morning and she submitted it to Cigna without delay.  I asked if I
should call the number on the back of my card on Monday to make sure that they are reviewing it and she said that was not necessary since we will probably hear from them either Monday or Tuesday.  WHAT?????  When I was finally able to breathe again, I asked her if we would be hearing an answer then, or just a courtesy call.  She said "With Cigna?  An answer."
WHHHAAAAT?????????
I told her that I had heard it could be up to 45 days and she said that
was if she mailed everything.  She sent it to the review nurse personally.  As I start rooting through my purse for Xanax, I tell her a bunch of thank yous and alot of stammering and she just laughed and said that she looked over everything and got excited because I was one of the few who had everything and she didn't see me being denied unless I had an exclusion in my policy.  As I swallowed the second Xanax I told her that they told me that I didn't.  She said that if I didn't hear anything by Wednesday to call her back.  I called my Benefit Center and spoke with Dillon and he said that there were no exclusions.  Oh-My-Gaw!  Is this really happening?

I had my last PCP visit today!  Yeah buddy!!!!  I went right from her office to the UPS store and overnighted the documentation from the past 6
months.  When I got back to work I first called Sheryl (Dr. Cribbins
Coordinator) to tell her that they will be there by 10:30 tomorrow morning and then I called Mom, Dad and all my siblings (I know they are at school, but I couldn't help it!).  I hope that I can keep myself from
"over-medicating" (haha) during these next anxious weeks!  I am so excited to finally be able to say...
I'M WAITING!!!!

Today I got a call from Sheryl, the Bariatric coordinator for Dr. Cribbins, wanting to make sure I sent her the doctor info yesterday after my last supervised visit.  I had to tell her that my appointment was rescheduled to Thursday.  Wasn't that awesome of her?  I only casually mentioned that the appt was on the 14th and she was waiting on it.  That just made me feel so much better in my choice of surgeon!  I'm finding that my obsessions and anxieties are taking turns and just when I get one settled and on the back burner, another one creeps up gets me going.  Now I am scared that I won't have my money saved up in time for surgery.  I have only $700 or so in the bank and I need $3500!!  I don't know why I haven't been on this like I know I could have been.  I guess I'm just going to HAVE to put away $100 a week along with any holiday pay I'll get.  But that would only get me where I need to be by the end of December.  Maybe I can cut back on my cable and sock away the difference.  That might get me $50 a month so that would up my goal date to the middle of December (not worth missing all my soaps :).  Hopefully some weeks I can sock back $200 and that could help.  I figure when I get a surgery date I can either let all my bills go except for rent (maybe I can work something out with my landlord) and save my whole check, or see if they will let me pay 1/2 or so of my copay and pay out the rest.  Also, maybe I will get a surgery date in November and I will know that no changes to my insurance will take place next year and have it after Jan 1st and can either make my copay smaller or use my income tax check.  As always, my mom said that whatever I don't have saved up by my surgery date, she will take care of and let me pay her back, but I don't like depending on anything coming from someone else.  Anyway, none of this matters, because next week I'll have another concern!! haha

Today I got a call from my PCP's office and they want to reschedule my
appointment for the 17th.  Aaagghh!!  It's like something wants to make me give up, but hahaha they can't!!  So I will be there bright and
early at 8:00 for my 8:15 appointment with a smile on and then I'll be on their a$$ for the paperwork for insurance. lol  Well, I am starting
today with walking for an hour 4 days a week.  My son started football
practice yesterday and I found out that he will be practicing Mon, Tues,
Wed and Fri at 6:00 - 8:00.  Personally I think that is much for 1st and
2nd graders, but I always have been "too much of a mom" regarding those sorts of things.  My brother is the assistant coach and said that he thinks it would be ok if I left for an hour to go walk around the block a few times.  This way I won't have any excuses and it would be better
than standing still for two hours in the heat.  I'm going to try to at
least walk for 30 minutes, but push for an hour.  Maybe I'll take my
mom's dogs out to walk with me.  Anyway, we'll see how it goes, because I haven't been all into Denise Austin like I was in the beginning (who am I kidding?...the first day).  I've been feeling so much like I will fail at wls.  I read a post on the messageboard where a pre-op was questioning post-ops for making such bad choices so early out.  I feel the same way she does, but she just got SLAMMED with post-ops saying that it's so hard and everyone slips, etc.  It was just literally 80 some-odd replys about negative things that can get you to fail and it just bummed me out.  I tell myself that I will not eat fast food 2 weeks after my surgery, but will I?  I feel that I have waited so long, I will appreciate it enough to do the right thing, but will I?  Oh, it just made me feel so discouraged.  Maybe I need to stay off the messageboards for awhile.  It seems there is nothing but b!tches on it lately.  I'll stay with my Texas Board...they are all sweethearts!  Hey, let's face it, we're just more friendly in the south!!!!  Ya'll come back now, ya hear?

Today I went back and read some of my earlier posts.  Now I'm scared of anesthesia awareness again!  I'm such a damn idiot!!!!

I called Sheryl, the Bariatric Coordinator for Dr. Cribbins, to make
sure that she had everything and is only waiting on my medical records and doctor referral letter.  She told me that all she needs is
documentation on the 6 month diet and that the medical records and doctor letter are not necessary.  WooHoo!!!  Because I have only started seeing a doctor 2 years ago or so.  I am still going to have my PCP and Gyno write letters.  Couldn't hurt huh?  Sheryl gave me the address to send the info to and she said she would call me if she needed anything else.  She said that I can make an appointment to sit down with her and go over everything she has, but I told her that I want to save my days off in case I can get my surgery this year.  Oh wouldn't that be awesome?  Ok, excuse me while I spend a few minutes in OCD land....I am sending her all my stuff on the 16th of August (hopefully) and "they" (people on OH and Cignasqueakywheels.com) say it can take up to 40 days for Cigna to answer.  That would put it at me hearing something by October 11th at the latest. 
~~If I am approved (oh joy!), I have to give a month notice at my work
(and if the doctor has the availability) I could look at the end of
November for my surgery.  Early Christmas present???  Which would be cutting it close at work since my boss does not allow any time off the last two weeks of December except for Christmas day (sucks I know).
~~If I am denied (expecting this to happen), I will automatically
appeal on 13th (give a leeway for time to get letters, etc together) and
then it could be another 40 days for an answer.  That would put me at
hearing something by December 8th at the latest.  Hopefully that will be a yes and I would then tell my boss to "bite it" on the month notice. lol  I hope I can get it this year.  I am so afraid that I will get approved
with a surgery date of 2007 or worse, I will still be in the appeal
process and once the new year starts, my insurance will change and WLS will no longer be covered.  If that happens, at least I will know during Cigna's open enrollment at my work in November.  But if nothing on my insurance changes, I would like to have surgery next year so then I can change my plan to have it to where I pay more every week and have a smaller out of pocket expense (we get that option).  The $3,000 out of pocket this year is going to kick my a$$.  But I will still do it.  Oh, my head is racing!!!!

Ok, can you believe it?  I actually did what I said I was going to do!! 
I woke up at 6:00am (like usual) and instead of laying there watching
MTV videos until 7:00, I flipped the channel to Lifetime and worked out
with Denise Austin.  Was I able to keep up with her?  Hell no.  Did I
continue with the exercises when they broke into commercial instead of sitting on my bed and gasping for breath?  Hell no.  But something is better than nothing.  And I figure if I can attempt it every morning, I
will get better and will continue with it after the surgery.  I set my
dvr to record it M-F so that I will have some to do on the weekends.  I
need to buy Walk Away the Pounds on dvd.  The one I have is on video
and the only vcr we have is in my son's room.  Those videos and Denise Austin are the only ones that get me motivated.  I also want to get an ipod for when I start at a gym after surgery.  I used to walk on the treadmil to Jackyl in high school.  It's like driving to metal.  You go
faster when the music is faster.  Now I got that song in my head..."I
stand alone today.  How you feel?  Don't ask me how I feel.  I just know I feel this way....."