DeeSleeved427

DeeSleeved....who did your surgery?

So nobody in Raleigh or a date in March?

Hi largeininc! I'm right outside of Raleigh, had surgery with Duke metabolic weight loss center (durham) Monday 12/01/14. I started all my pre-op stuff at Bariatric Specialists of NC in Cary, NC But had to switch to duke due to insurance requirement. Loving my sleeve and progress so far. I started in May, I had a 6 month program for insurance so March will come quick!

My last appt is 11/24 for my required 6 mo for my primary care for weight loss maintenance! How long do I have to wait if my doctor sends everything to my surgeon that day? I hope I get my surgery in Dec.

From what I'm seeing, every surgeons office is different. I met someone here from my surgeons office who had everything finalized (ppwk to insurance, surgery date and insurance approval) within a week. But, me-all my ppwk done 10/17. Surgery date set on 10/21...however my ppwk sat there bc there were other surgery dates before me they had to submit first so I JUST got to insurance last Thurs 11/13, approval today 11/18. I hope you can get a December date as well ???? good luck!!

Finally got my approval from insurance. After finishing all my supervised diet visits and pre-op stuff in October, surgeon finally submitted me last Thursday 11/13/14 and I just heard it was approved today 11/18/14. Seemed like forever, especially considering my surgery date was set for 12/01/14-I was starting to freak out it'd go to medical review and push my date back. *Sigh* what a relief. It's actually happening now!!

Hello ladies! I just received my date for December 1st-I'm also very excited about finally reaching this point (I had a 6 month supervised weight requirement for insurance). My pre-op appointments are on 11/20 and 11/26 so I guess I'll also be on liquids the week of thanksgiving also. I believe my plan allows one lean meal per day so I'll get some nice turkey and veggies still ???? looking forward to seeing your progress!

Good question!! Just got my date 12/01 and I don't have a plan to follow until just before surgery. My natural plan was to cut caffeine so I won't be withdrawing while in pain-lol. Going to start reducing carbs more and sweets (hopefully cold turkey before the surgery). Looking forward to seeing the other responses ????

Hello all! Excited to join this group as I received my date: 12/01/14!! Looks like we'll have a great holiday season!!

Hello all! I hope you'll have me as I just got my date today, 12/01/14!! I thought I would be in Nov but due to the holidays and my surgeon only doing surgery 2 days a week I was pushed into December. Not bad at all ????

WOOHOO me too

Me three!!!

Your employer can require more than normal but the 6 month is a little unusual that's why I asked if it was a third party. We sell to other insurances and they use our rules and networks and administer some additional authorization rules

Thanks so much for all your help! I tried getting to authorizations but the lady didn't help me, she kept saying only the surgeon could call for pre-certification but I told her I wasn't trying to get certified but just confirm the requirements. Lol. I just ended up having hw transfer me back to customer service and the gentlemen said 6 months again. Lololol. I'm a week away from that last appointment so I'm just going to give up. I am now trying to get clarification on absolutely having to having the surgery at a center of excellence. There's only one close to me that is recognized but some good hospitals closer to me that aren't "Coe for bariatric".

I just got approved by Cigna! My Dr. opened my case last Weds (10/1) and submitted the paperwork that day. I guess an automatic letter was sent saying they needed more information (I received it on Saturday) but everything worked out and I was approved today! Very impressed by the turnaround time (3-4 business days).

Thanks to a cancellation, I will be sleeved next Tuesday, 10/14. Ahhhh!!!

Congratulations!! I know you're super excited hoping the same for me on 10/17 too!! Although I'm guessing they won't submit me until that following mon, tues or wed lol.

Do you have the open access plus plan?

@@DeeSleeved427 You and I are pretty close, then. My last nutrition appt is on October 15th at 4:30 PM. I have Cigna open access plan

Me too, open access plus ???? did you have to do the 90 days or 6 months?

Are you speaking to customer service when you call or are you telling the computer it's in regards to authorization? Tell computer authorization after medical

Then tell them tou are reading the policy (I posted link earlier in this post) and that it reads three months

Ask them why your policy requires 6?

Is it your employer or the third party payer policy?

Sorry, hit send too fast lol. I had only been calling customer service and they keep reading my plan requirements, most match the guidelines you posted except the 6 month and center of excellence being mandatory or they wouldn't cover it 100% like my plan says it will.

Are you speaking to customer service when you call or are you telling the computer it's in regards to authorization? Tell computer authorization after medical

Then tell them tou are reading the policy (I posted link earlier in this post) and that it reads three months

Ask them why your policy requires 6?

Is it your employer or the third party payer policy?

It's my employers hmo plan offering.

Center of excellence is normal saves more money. The 6 months is odd. Call Cigna directly and confirm that. Don't rely on the doc coordinator

I've called CIGNA like 5 times. Once just in hope that maybe the rep I got would say 3 months like the policy says, lolol. But each rep said 6 months dr sup diet, and only once did someone say center of excellence which is why I had to switch bariatric surgeons so late in the game (in month 5). What do you think I should ask exactly, maybe I'm asking the wrong questions-but the surgery coordinators for both my old and current center got 6 months from them too ????

Electronic medical records aren't signed.

I would think that is not an issue.

Also - why are you doing 6 months?

See the link i posted several pages back, Cigna requires an 89 day monitoring, not 6 months.

I saw the same thing and called many times about it, apparently it's just my employers policy (well my husbands lol). They are also making me use a center of excellence for bariatric surgery only per my plan ????

???????????????????? very very happy for you!! Closer to the losers bench ????

Loving this thread! Last 6 month visit for me is 10/17, hoping to have early nov surgery date. Wish my surgeons office would give me a tentative date, as all my lab stuff will expire on 11/22 (since I started in May)

I'm so glad I found this thread as I have Cigna and will be finishing my 6-month of supervised weight checks Oct 17th. I found out in month 5 that I had to switch Bariatric centers as there was only 1 center of excellence through my plan (required for my employer sponsored plan to cover 100%) so I've been nervous about approval having started in one place and ending in another (lol). All my records were faxed over to the new center and I noticed nothing is signed. I hope that doesn't create problems for approval since everything is electronic record. Anyone ever get delayed over signatures?

My last pre-op appointment is October 17th, hoping to be submitted for insurance approval early that week following so I can get an early November date ???? very exited for everyone who already has a confirmed date!!!

Best wishes Daron! I too was as BSNC, but due to insurance requirement I ended up having to transfer to Duke in month 5 of my 6 month pre-op wait. Very, very frustrating but I'm keeping my weight/bmi checks with BSNC b/c I was already scheduled with them and to keep all the paperwork consistent. I was with Dr. Bruce. My last visit with them in Oct 17th and then I'll fax my last ppwk to duke that afternoon and hope they can submit to insurance beginning of that next week so I can get on the books!

I'm hoping to be sleeved no later than Nov. 22nd b/c that's when all my labs/work-ups I did with BSNC expire (I read somewhere about a 6 month validation).

Hello lucky! I saw on another board that you are having (or maybe already had) your surgery through Duke. I too am going through Duke (after starting with Bariatric Specialists of NC-but due to insurance requirement I had to switch to Duke). Who was your surgeon and how did everything go?

I am doing my 6 month visit at BSNC on Oct 17th (still seeing them for the weight/bmi checks) and then sending off my last forms to Duke so they can submit for insurance approval. How did that approval process go for you? I'm so nervous b/c I had to switch surgeons 5 months into it, and I feel like something will be left out since technically I'm a new patient to Duke and I'm just like "hey schedule a surgery for me!" lol

I have CIGNA and in NC, I have the 6 month wait, won't have my 6th visit until Oct 21st so I hope the July 1st changes (if approved) travel through my insurance pipeline as well! Thanks for the info and best wishes to you all!

I had my sleeve done almost 2 months ago by Dr. Bruce at Bariatric Specialist s of Nn..He was great!!

That's awesome @@suzysuz86 !! How has you recovery/experience been thus far?

I'll definitely plan to attend