Jim1967

Just got word this morning Cigna finally approved!! Surgery date is April 16

Approved!! Monday I was denied and this morning I got the call stating the approval is in. 5 months worth of food journals and exercise logs finally won them over. Thanks to all of you for mojo I really needed it. It's been a long week but now I am starting off the weekend with a bang!! Surgery date is April 16

Oh yea...forgot to mention I do have sleep apnea. They know all that as well. I have gotten so used to sleeping with my CPAP that I sometimes forget why I have it. If that makes sense. We are appealing. We are providing them more documentation along with food journals and exercise activity. Thankfully the Center I am working with is a great advocate. I was impressed that my actual surgeon took the time and made the call on my behalf and didn't staff it out. They're going above and beyond in my eyes.

Wow I am really bummed.... I got a call from the Center yesterday and they told me my Surgeon spoke directly with the doctor at Cigna and got shot down stating there is no medical necessity. Seriously? I know I am very healthy considering my 455 pound frame but c'mon!! I guess I need diabetes or high blood pressure to convince them? Or better yet a heart attack? but I may not survive that. I watched my father live through that and it wasn't pleasant. Sorry for the rant and pity poor me party but I am just frustrated. I have done everything asked of me. I went to all the support classes and took a binge eaters 6 week support program. Changed my eating ways and dropped 32 pounds. I have passed all the preop testing with flying colors and was checked and probed by a 3rd party doctor who told me I have to be the healthiest overweight person he's ever met...

Center I am going through already faxed additional information to Cigna. I pointed out that I am shy by a few weeks of 6 months and the person I am working with said that is OK. We'll see what happens...

Yep that's me. Nancy is working on it and told me not to worry she deals with this all the time. It might just take a bit longer.

Thank you. They are submitting additional documentation today so hopefully that will do it.

First off one reason for the denial was because they had me listed as being under the age of 18 (I wish). I haven't been a teenager in a very long time so that part is quickly resolvable. Second part is incomplete documentation of a 6 month physician supervised weight program in the last 24 months and incomplete documentation of a 6 month physician supervised weight management program within the past 5 years without significant gaps. Now technically my 6 months is not up until April 12 but the Center was trying to get me approved now so I can have the surgery on April 16. They are going back to work with Cigna on getting what is needed and get my DOB straightened out. Hopefully they will be able to convince them. I have learned that while knowing in the back of my mind receiving a denial letter the first time around is not suprising however it still struck a nerve and yesterday was not a great day mood wise.

Thanks for the denial Cigna....I half expected it but the blow to my morale is complete.

I received a denial letter today from Cigna. Cigna requires 6 month supervised diet and my Doc office submitted early by 2.5 weeks. Cigna also said I was under 18 and they cannot approve. LOL... I haven't been a teenager in a very long time. Edit: Information was submitted on 3/15 and the denial came today so it was a quick turn around telling me to go pound sand....

Here is a pretty decent comparison chart side by side. http://www.wlshelp.com/lap-band-vs-realize-band.html I also have no idea which band at this point my surgeon is going to go with. I guess I'll find out as soon as I get a date.

Thank you and good luck to all. :-)

Laughing Cow is good stuff. I like the sour cream and onion and onion and chive.

Has anyone tried the unjury chicken soup? Opinions? http://www.unjury.com/store/protein/reg/chicken_soup_flavored_protein.shtml

Congratulations Tracie...you are doing awesome!!

This is what concerns me the most. I lost 174 pounds between 2003 and 2004 doing Atkins. It worked very well for me but I screwed up and over the years I gained all the weight back plus an addtional 80+ pounds. Christmas of 2004 I was in Disney World with my family and I felt like I was top of the world. Fast forward to today...I am 454 pounds. I am very nervous that I am going to lose all the weight again just to fail and gain it back. I like to think I learned from screwing up the first time but it's so fresh in my mind. I had a Support class a few weeks ago and someone said "I just want to lose the weight and forget I had to go through the surgery to do it" I don't ever want to think like that. I want to be able to reach down and feel my port. I want to see my scars daily. I want the constant reminder of where I was and where I am going and how I never want to go backwards again... Sorry for the life story...but I am not nervous about losing weight...I am worried about gaining it back after I lose it.

I am going through what is called a Center of Excellence. It is basically an all-inclusive practice consisting of Surgeons, Nutritionists, Mental therapists..etc. I go in once a month sometimes more if I happen to be there for an appointment or support meeting and I weigh in. They told me to weigh in and record it and make sure I sign in on my meetings and they will put the package together to present to insurance when the time comes. You said you already spoke to your insurance rep but one thing I recommend is get the bariatric coverage policies in writing so you have complete understanding of what is needed. Some insurance companies expect certain documentation such as weight, exercise activity, doctor visits and such. It is very important you have this knowledge cause insurance companies can be very picky. Good Luck!!

Wow sorry to hear your Mom took it so bad. Seeing that she walked your (similar) shoes years before I would expect she would understand completely. Then again 25 years is a long time. Maybe she forgotten how restrictive the eating was. She also had bypass and not a band so maybe she just doesn't understand.

Welcome all!! This forum is such a valuable asset in a sense you can research, get advice and most of all encouragement!!

What's funny is when I met my Surgeon he told me if he had the choice he would schedule surgery right now. He feels 6 months is too long to put pressure on patients. They ask you to lose 10% of your weight prior to surgery and he said most people do OK for the first couple of months but tend to start gaining it back before insurance approval can be met. He went on to further say that operating at the lowest weight is beneficial as your liver shrinks with the weight loss. He said people tend to yo-yo over 6 months that he would rather just do a 3 month wait. I have lost 32 pounds since October but yet only lost 5 since Dec 5th. I never fully re-gained my motivation after the holidays. :-(

I am also lingering along waiting for my 6 months to be completed so I can move on to the next step. Center I am going through has pretty much told me I am ready. I have met all their requirements and done all testing needed with exception to a physical closer to surgery date. Now that most of the tasks are done I find myself losing steam a bit while waiting for time to pass by. This forum is such a valuable tool along with Jean's Bandwagon book. Good luck to you both.

I would love to Kayak. I tried it many many years ago when I was not so big and I enjoyed it quite a bit. I would also like to participate in some Cancer charity walks. I've quite a bit of cancer survivors and losses in my life and would like to somehow do something for them. I guess the rest of it is really everyday things that most skinny people take for granted. Like going to a restaurant or movie or a concert and not worry about seating. Being able to travel on a plane and not have to fly first class because of my size.

Wow Allision you're doing great. 7.5 months and 98 pounds gone that is awesome. I can only dream of that success if my approval ever comes. thanks

Based on my size alone my Surgeon told me to expect a night stay. It really depends on your suregon, your current health. If you have comoridities such as high blood pressure or diabetes that alone may warrant a night stay.

Good Luck to you all. I have Cigna and I am in the process of completing my 6 month supervised diet.