geno5150

If it were me, I would stop at a good restaurant, get something to go, and then sneak it in to Red Lobster or Olive Garden and eat it.

My reflux has definitely gotten worse since surgery- I'm almost 8 months out now, but it was expected to do so. I still have the same amount of acid, but an 80% smaller stomach to hold it. I was switched to omperazole and that keeps it in check for the most part. I had a family member die from esophogeal cancer caused by reflux which then spread to her lungs and all over, so I'm pretty careful and will get scoped regularly to be safe. If you have refulx, I would advise everyone to do the same.

How often do you weigh yourself? You can and will fluctate quite a bit on a daily basis, so you may want to consider weekly or even monthly at most. All the up and down can be really irritating for people that like an orderly approach to life.

Your surgeon knows the hoops you need to jump through. He doesn't get paid unless you are approved for surgery, so it's in his best interest to document your case per what the insurance company requires. If you aren't approved, you will be told why so you can get your doc to either do what they need or document it properly.

As long as you are not gaining 2 pounds a day, you should be OK. It's a marathon, not a sprint.

The first time I had reflux, I thought I was having a heart attack because the pressure and squeezing was so intense- I spent the night in intensive care and left with a perfect heart, a prescription for Protonix, and a bill I am still paying off..

It's normal. As long as you are losing on a monthly basis, you are doing fine. I would stop weighing yourself so much. Thiese fluctuations are very normal.

Glad I could help. Good luck to you!

Don't be afraid to call them and ask if you are unsure of anything. You are paying the bill, so make them work for you. BCBS-TX is a fairly easy company to work with and provided you meet the policy requirements and have all the paperwork in, you should be fine.

Generally, what they mean is that they can see the paperwork has been recieved, but the area that reviews the information has not made the approval/denial decision. It is neither good nor bad, just the step of the process you are on. I would continue to check in with them on a daily basis to see if a decision has been made- it should happen in the next day or two.

My insurance coordinatior told me the same thing, but in reality had not sent all the paperwork over. She was also wrong about the insurance company requirements- they deal with many different companies and sets of requirements, so mistakes happen way more than you think. I would highly suggest calling CIGNA yourself and double checking because you have no idea what they have received from your doctor or what may be missing. You are always your own best advocate.

I would call CIGNA myself and ask them what information they currently have and what specifically is missing. Then I would call the doctor and relay that same information, then calling CIGNA every day and checking to see they have received it, then following up with the doctor to find out why it has not been sent. At lest you don't need to go the appeals route yet- that's a plus in your favor.

You're quite welcome. You can also ask them to fax the approval to the doctor so you can get moving on scheduling the surgery. This will save time waiting for the post office to deliver the letter. Don't fear your insurance company. You are paying the bill, so don't be afraid to ask questions. Each one has a medical policy that defines what is and is not covered and how to qualify- it's not secret information. As long as your company has not excluded it, you should be good to go in most cases.

Just ask them what information they have and what they still need in order to approve. It's most likely an honest mistake or some missing paperwork.

That doesn't sound right. Obesity in and of itself is not a comorbidity. The BCBS-IL medical policy states: BMI equal to or greater than 35kg/meters² with at least two (2) of the following comorbid conditions related to obesity that have not responded to maximum medical management and that are generally expected to be reversed or improved by bariatric treatment: Hypertension, OR Dyslipidemia, OR Diabetes mellitus, OR Coronary heart disease, OR sleep apnea, OR Osteoarthritis If you have a BMI of over 35 you also need two of the above list. If you BMI is over 40, then you shouldn't need any co-morbidities. I would call BCBS and ask them why you were denied- don't wait for the doctor's office to do it.