Kathy1991

Pam, DANG! Are you OK? That's ALOT to go through. I'm sorry you had to go through all of that. I will say, your heart better be ok after that!!!!!!!!!!!! :thumbdown:) Hang in there!!!!! Thank you so much for the feedback. I'll call and find out what I need updated by next month. They need more staff at Duke (duh)! Thanks again, Kathy

Hi, what ARE the rules on that? I went to Duke in October. But had tests done in the year before that. For example, I had my stress test done last Feb. 07. Had blood drawn maybe in Aug. 07. I'm done w/ my 6 months pre-lapband diet in April and expect my paperwork will go up to insurance from there. Do you guys have any idea what times limits are on some of these tests? Thanks Kathy

Hello, I am 3 months into my 6 months diet w/ my doctor. I have noticed that in the last couple of months my back is hurting more and more. The last 2 days, I can hear it 'pop' when I walk or twist. Has anyone else had this? Any advice on how to relieve the pain, other than ibuprofin and weight loss? Special exercises? I have started working from home more and more. I often work while sitting on the sofa and think this is adding to my discomfort. Can anyone say 'couch potato'? I feel I truly am one. Thanks guys! Kathy S. :biggrin:

Hi Jennifer, I live in Cary. I am half way (3 months) through my 6 months of doctors visits and will be banded by Duke WLS. I know there are some folks that have not had a positive experience with them, but I have not had the same experience. Things have gone good for me. I hope things go great for you. I liken the Duke experience to the way they are building in Wake County....it's growing so much they can't keep up. :tongue:) I understand the frustration some folks feel, but I believe it will get better. Wish for those that have had an issue would have been able to have had a better experience. Thanks, Kathy S.

Hello all, I am in the pre-stages of getting banded. I have all the blood work done and have had the barium swallow. During the swallow, my doctor noticed a "Very slight hiatal hernia" but it states "no obvious abnormality" on the x-rays. Has anyone else experienced this and did it impede your progress for getting the band? Thank you! Kathy S.

Hi, I have Cigna. Here is what mine says: Coverage Position Bariatric surgery is explicitly excluded under many CIGNA HealthCare benefit plans and may be governed by state and/or federal mandates. Please refer to the applicable benefit plan document to determine benefit availability and the terms and conditions of coverage. Unless excluded from the benefit plan, this service is covered when the following medical necessity criteria are met. CIGNA HealthCare covers bariatric surgery using a covered procedure outlined below as medically necessary when ALL of the following criteria are met: • The individual is ≥ 18 years of age or has reached full expected skeletal growth AND has evidence of one of the following: BMI (Body Mass Index) ≥ 40 for at least the previous 12 months. BMI (Body Mass Index) 35–39.9 for at least the previous 12 months with at least one clinically significant comorbidity, such as a serious cardiopulmonary problem, Type 2 diabetes, hypertension, coronary artery disease, or pulmonary hypertension that has failed to respond adequately to appropriate medical management. • Active participation within the last two years in one physician-directed weight-management program for a minimum of six months without significant gaps. The weight-management program must include monthly documentation of ALL of the following components: Ok, now, I read this and thought I wouldn't be covered. BUT, I looked on the website for the weight loss center (I live in North Carolina so Duke will do the surgery). It specifically states the codes to ask your insurance company about. So, I called Cigna, armed with this information. They took my member number and checked to see if indeed I am covered. Also, I called once before the information session at Duke. Then, I called again after that session (just to make sure). They even gave me the complete thread, using my membership information, to find this on the website. Insurance companies are not easy to deal with in general. But I have to say, I have been encouraged to this point with the answers I have been getting. I encourage you to call them and ask them directly if the code is covered. Here is the specific question list I used to ask Cigna about coverage: 1. Is Morbid Obesity a covered benefit in your policy or is it an EXCLUSION? Give them the diagnostic ICD9 Code of 278.01. If morbid obesity is a covered benefit, check that the operative procedure you are considering is also covered. For the Roux-en-Y procedure give them the CPT Code of 43846 or 43644 and for the LapBand procedure give them the CPT Code of: 43643 (Note that many insurance companies do not yet approve the LapBand Procedure so check carefully with your company if this is your selection). Finally ask if your hospital and the doctors you want to use are covered by Cigna. And lastly, I think that the code for LapBand is now 43644, but not certain. What I would do is give them the 43643 number and then ask if there is any code covered for it and take that info down. Then call the folks doing the surgery and ask "Is this the code that will cover my procedure." I hope this helps! Ks

Miss North Carolina here. Cary, North Carolina....

Hi there, what's a '6 month deal'? I'm so unfamiliar w/ some of the terms. Is this a 'pre-band diet'? Thank you! Kathy S.

Hello, I also have Cigna insurance. My doctor will submit all my paperwork in Sept. when I go for my clinical. On average, how long did it take some of your folks to hear back from Cigna that they approved you? Thank you!! Kathy S.

Hello all, I live in Cary, NC. I am in the preliminary stages of getting my band and have the barium swallow on Monday (I'm terrified). I will be banded at Duke University and have my clinical on Oct. 4th. I'm very excited about the entire process. I have two children, a 9 year old boy and an 11 year old girl. I have been married for 16 years and tomorrow is our anniversary. I will be glad to be able to cross my legs w/o one falling off the other (HA). I am hoping for better vital signs also. Wouldn't it be nice to not have 'high sugar levels and high BP'. I realize some of this is up to me, band or no band, but I am certain the weight loss will only benefit me. Thanks! Kathy

Hi ya'll, I'm new to all of this. Once you have the band in, can you drink soda? I love my diet coke!! Thanks, Kathy

I want to be able to cross my legs w/o have one of them fall off the other!!!!! )

Hi Amy, I am just now getting into the process to be banded. I have my insurance all figured out and am attending a session for lapband on Friday. I confided in a friend of mine and she was very strange to me. It was one of those instinctive feelings of 'disapproval'. She and I have tried to lose weight together before and like other folks here, she's been an eating buddy. I haven't even gotten very far and I feel like I am already getting 'push' from some folks. I loved the idea of trying to find someone local to get to know that has had the band. Take care!!! Kathy in NC

Hi All, I am new to this forum and have just started the preliminary steps to getting banded. My insurance WILL cover the surgery (yeah!!) and I am going to the information seminar on Friday. Has anyone on this Forum had their surgery done at Duke University Hospital? I did a search and didn't come up with anyone, but I maybe didn't look hard enough! Thank youuuuuuuuuuuu!! :nervous