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Wow, it's almost 3 years later and I'm 100 lbs down!
Hey Guys/Gals,
Soooo, it definitely didn't work out at the first doctor's office; hence I had to START ALL OVER WITH MY INSURANCE PROCESS
Luv, just know...I've been there- rejected over and over again... dont give up- keep moving forward and find a different doctor if you have to!
Okay, I haven't even read my last post. I was so upset and depressed from the failures of that doctor's office ....
The doctor who performed my surgery. The paper work was a breeze.
Please note, you may need your gallbladder removed.
This happened to me!
I never recovered from my surgery. I lost 55 lbs. in 1.5 months and please luv trust me, it was painful. It wasn't the correct way.
I couldn't eat ANYTHING, well. Popcorn.
I was completely weak, couldnt take care of my family and thought I was going to die!
It took the doctor 2 months to find out what was wrong with me!!!!! It was crazy.
So, after going from ER to ER, I got tired of the doctors coming up with a blank and requested to be submitted in the hospital under obersavation. This saved my life!
They scoped me the next day and realize my gallbladder was sandy going bad, the next day they removed it.
I was sick for soooo long it took me 3 weeks to heal and feel better.
I lost tons of weight, but it was mostly muscle! (Crying)
I've been an athletic all my life- yes I lost fat, but because I could eat for 2 ml this literally, my musical wasted to keep me alive.
So, after I healed- I got a personal a trainer and worked out. Honestly, I felt like I should have been in rehab...good ol' USA, insurance...
So, to date- I'm healthy and sooooo happy!
Recall, I've lost over 100 lbs. I went from a size 22 to a size 6! Crazy right....
It feels good, but it takes work .
I still have to watch my eating habits and the sweets. I'm almost 3 years out, y ok u stomach WILL stretch and get bigger, meaning you can gain ALL THE WEIGHT back.
You must realize why you want/had the surgery and change your life style. If not it's a waste of time, money, energy, and possibly your life .
Soooo, it definitely didn't work out at the first doctor's office; hence I had to START ALL OVER WITH MY INSURANCE PROCESS
Luv, just know...I've been there- rejected over and over again... dont give up- keep moving forward and find a different doctor if you have to!
Okay, I haven't even read my last post. I was so upset and depressed from the failures of that doctor's office ....
The doctor who performed my surgery. The paper work was a breeze.
Please note, you may need your gallbladder removed.
This happened to me!
I never recovered from my surgery. I lost 55 lbs. in 1.5 months and please luv trust me, it was painful. It wasn't the correct way.
I couldn't eat ANYTHING, well. Popcorn.
I was completely weak, couldnt take care of my family and thought I was going to die!
It took the doctor 2 months to find out what was wrong with me!!!!! It was crazy.
So, after going from ER to ER, I got tired of the doctors coming up with a blank and requested to be submitted in the hospital under obersavation. This saved my life!
They scoped me the next day and realize my gallbladder was sandy going bad, the next day they removed it.
I was sick for soooo long it took me 3 weeks to heal and feel better.
I lost tons of weight, but it was mostly muscle! (Crying)
I've been an athletic all my life- yes I lost fat, but because I could eat for 2 ml this literally, my musical wasted to keep me alive.
So, after I healed- I got a personal a trainer and worked out. Honestly, I felt like I should have been in rehab...good ol' USA, insurance...
So, to date- I'm healthy and sooooo happy!
Recall, I've lost over 100 lbs. I went from a size 22 to a size 6! Crazy right....
It feels good, but it takes work .
I still have to watch my eating habits and the sweets. I'm almost 3 years out, y ok u stomach WILL stretch and get bigger, meaning you can gain ALL THE WEIGHT back.
You must realize why you want/had the surgery and change your life style. If not it's a waste of time, money, energy, and possibly your life .
Hi everyone, this is my very first post! I have...
Hi everyone, this is my very first post! I have not had the best experience trying to get my procedure approved. I will continue to document my journey as it's still in progress. (Hence no surgery date:( ). I pray this we'll help someone else as a lesson learned by my unfortunate events.
I started this journey in May 2014. I have Cigna, so they only require a 3 month nutritional/weight management plan, along with the other requirements.
I'm some what tall and carry my weight well, though I'm extremely over weight. After I met with the surgeon, who was very nice I visited the patient coordinator to review insurance requirements. The first thing she said was, oh your self pay. Cigna will not pay. Me --> Huh? Lol is what I'm thinking. I asked why, she said I didn't look like I had a BMI over 40, well it was 43 and weighed around 262 just verified during my office visit.
I questioned why would you say that. She stated Cigna required patients to be obesed for 5 years and must prove a consistent 40 BMI for the entire 5 year duration. I was completely sadden, because I had only been this over weight for ~2 years and it was extreme health problems. So. Before I could really even start my process, I felt defeated. Yes, crying was involved. I didn't have the $12,000 for the self pay and thought my insurance would cover the procedure based on the statements of the patient coordinator.
So, I was depressed for several months, until something told me to actually call my insurance company to verify the 5 yr 40+ BMI statement. Well, what do you know, this was not true! Cigna request a 2-3 year history, yet doesn't make their decision on this along. ( Please do your homework)
It's now, August 2014 and I begin my 90 day nutritional/weight management with my personal doctor along with ALL of the other doctors you must see for approval (it was a lot of appointments, lol).
Okay, fast forward to November 2014, I've just completeled my last appointment with my personal doctor for the 90 days medical review and receive my medical clearance which my insurance require, along with 2 year medical history, and documentation of workout and weight lost plan, I used weight watchers. I also did the psych evaluation, sleep apena evaluation, nutritionalist office visit (1 of 2 the surgeon require), and a group weight lost meeting.
I'm so excited at this point to get everything turned in to the office and submitted for a possible approval! Well, I submitted all of my documents prior to Thanksgiving 2014. The patient coordinator submitted 3 weeks later, I'm not sure if this is normal, but felt like this took a while.
At this point, I was on pins and needles...calling Cigna almost daily for status (nervous and excited!). Well, they said the office didn't submit all of my
documents...huh? So, I tried to follow up with the surgeons office but no one would answer the phone, so I left voicemails thinking I would get a call back due to the holiday. Well, 1week later I got a reply back...I was okay with this, Christmas had just pass, so I understood ,vacations. Well, when I got them on the phone the patient coordinator stated all documents were turned in and but she'll resend. I'm thinking great!! Cigna didn't sound like they would deny me, they only needed my 90 nutritional/weight management doctor's notes. I knew she had these because my personal doctors office staff faxed in my presence to the surgeon's office.
Now my friends, we're in January 2015. I call Cigna and once more I'm told they don't have all of the documents, but when I communicated (email/phone) with the surgeon's office she states everything is turned in and pretty much left it as such. At this point, I'm feeling extremely lonely in this process, there are major discrepancies from my surgeon's office and insurance company.
I'm not sure if anyone can relate, but bring over weight is debilitating. I have high
cholesterol, GERD, acid reflux, high blood pressure....I'm 32 at this point. So to place you in my mind set, I would follow up with the surgeon's office 2-3 a week for status up dates, well my reception turned cold and dry.
To be honest, I never felt welcomed by the patient coordinator once she told me my insurance company wouldn't cover me back in May 2014.
It's late...I will follow up my journey tomorrow, it's 31Jul2015 and sadly I'm still pending approval. Needing support and advise, but I will continue to document my journey, I'm not giving up!
I started this journey in May 2014. I have Cigna, so they only require a 3 month nutritional/weight management plan, along with the other requirements.
I'm some what tall and carry my weight well, though I'm extremely over weight. After I met with the surgeon, who was very nice I visited the patient coordinator to review insurance requirements. The first thing she said was, oh your self pay. Cigna will not pay. Me --> Huh? Lol is what I'm thinking. I asked why, she said I didn't look like I had a BMI over 40, well it was 43 and weighed around 262 just verified during my office visit.
I questioned why would you say that. She stated Cigna required patients to be obesed for 5 years and must prove a consistent 40 BMI for the entire 5 year duration. I was completely sadden, because I had only been this over weight for ~2 years and it was extreme health problems. So. Before I could really even start my process, I felt defeated. Yes, crying was involved. I didn't have the $12,000 for the self pay and thought my insurance would cover the procedure based on the statements of the patient coordinator.
So, I was depressed for several months, until something told me to actually call my insurance company to verify the 5 yr 40+ BMI statement. Well, what do you know, this was not true! Cigna request a 2-3 year history, yet doesn't make their decision on this along. ( Please do your homework)
It's now, August 2014 and I begin my 90 day nutritional/weight management with my personal doctor along with ALL of the other doctors you must see for approval (it was a lot of appointments, lol).
Okay, fast forward to November 2014, I've just completeled my last appointment with my personal doctor for the 90 days medical review and receive my medical clearance which my insurance require, along with 2 year medical history, and documentation of workout and weight lost plan, I used weight watchers. I also did the psych evaluation, sleep apena evaluation, nutritionalist office visit (1 of 2 the surgeon require), and a group weight lost meeting.
I'm so excited at this point to get everything turned in to the office and submitted for a possible approval! Well, I submitted all of my documents prior to Thanksgiving 2014. The patient coordinator submitted 3 weeks later, I'm not sure if this is normal, but felt like this took a while.
At this point, I was on pins and needles...calling Cigna almost daily for status (nervous and excited!). Well, they said the office didn't submit all of my
documents...huh? So, I tried to follow up with the surgeons office but no one would answer the phone, so I left voicemails thinking I would get a call back due to the holiday. Well, 1week later I got a reply back...I was okay with this, Christmas had just pass, so I understood ,vacations. Well, when I got them on the phone the patient coordinator stated all documents were turned in and but she'll resend. I'm thinking great!! Cigna didn't sound like they would deny me, they only needed my 90 nutritional/weight management doctor's notes. I knew she had these because my personal doctors office staff faxed in my presence to the surgeon's office.
Now my friends, we're in January 2015. I call Cigna and once more I'm told they don't have all of the documents, but when I communicated (email/phone) with the surgeon's office she states everything is turned in and pretty much left it as such. At this point, I'm feeling extremely lonely in this process, there are major discrepancies from my surgeon's office and insurance company.
I'm not sure if anyone can relate, but bring over weight is debilitating. I have high
cholesterol, GERD, acid reflux, high blood pressure....I'm 32 at this point. So to place you in my mind set, I would follow up with the surgeon's office 2-3 a week for status up dates, well my reception turned cold and dry.
To be honest, I never felt welcomed by the patient coordinator once she told me my insurance company wouldn't cover me back in May 2014.
It's late...I will follow up my journey tomorrow, it's 31Jul2015 and sadly I'm still pending approval. Needing support and advise, but I will continue to document my journey, I'm not giving up!
Provider Review
Cameron
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