Tobeornottobe

Your hubby is awesome! Not exactly a Dr. Who fan but I have watched some :-)

Congrats on your date! Good luck on your journey.

I totally understand where you're coming from. Have you spoken to your surgeon, nutritionist or PCP about your concern?

Maybe this is some thing you should discuss with your PCP or surgeon.

Congrats!

Welcome and best of luck on your journey.

Congrats and Happy Birthday!!!!!!!!!!!!

It stinks that this happened to you. I have had some issues with the surgeons office as well. I kept on them constantly. I also made sure I had copies of all the information they had.
Good luck and let us know how things turn out.

Good luck on your journey!!

Congrats!!

I totally understand how you feel. I'm scheduled for surgery next week. I too have been having second thoughts. However, we've come this far so hang in there and know you are not alone in this journey and the way you feel is completely normal.
Good luck.

I totally understand how you feel. I'm scheduled for surgery next week. I too have been having second thoughts. However, we've come this far so hang in there and know you are not alone in this journey and the way you feel is completely normal.
Good luck.

Wow so many people on December 8th. Good luck all.

Wow so many people on December 8th. Good luck all.

Casseroles travel really well. I sometimes wait until I get to my destination to pop things into the oven (this is a great option if you can do it). Shepard's pie travels well as do parsnip mash. Spinach and artichoke dip can be served warn or cold. It reheats easily in a microwave. Buffalo chicken dip also travels well and is easy to reheat in a microwave.
Hope this helps.

Wow so many people on December 8th. Good luck all.

You should check this out really well, since your husband is still covered his insurance, his insurance would be primary and your insurance would be secondary. The general rule of thumb is they go by what the primary insurance covers. You should look into this before your husband starts the process.

You should check this out really well, since your husband is still covered his insurance, his insurance would be primary and your insurance would be secondary. The general rule of thumb is they go by what the primary insurance covers. You should look into this before your husband starts the process.

Is COBRA available? Can you buy your own insurance on the healthcare exchange or through a broker? You do have options. Good luck.

You can start now. I started the process with United Healthcare and hubby and I both changed jobs and our health insurance changed to Cigna. My timeframe changed from 6 months to 3 months. So instead of having surgery in Feb/March of next year, I'm going in on December 9th.
When we moved to Cigna, I called Cigna and got them to email me the criteria and verified benefits, co-pays, etc.
As far as nutrition, WW and Jenny Craig are acceptable as long as you are supervised by a medical doctor. Cigna does not require a day to day accounting of what your diet. The nutrition component is mostly to know you are equipped with the information to make you successful after the surgery. Monthly weigh-ins are also required. I visited my doctor's office once a month to be weighed. My surgeon has nutritionists in his practice so I used them for documentation. Please note: Cigna requires 90 days of documented nutrition information, not 89 but 90. I did 4 nutrition visits to be safe.
These are the Cigna requirements:
Medical management including evidence of active participation within the last 12 months in a weightmanagement
program that is supervised either by a physician or a registered dietician for a minimum of
three consecutive months ((i.e., ≥ 89 days). The weight-management program must include monthly
documentation of ALL of the following components:
weight
current dietary program
physical activity (e.g., exercise program)
Programs such as Weight Watchers®
, Jenny Craig® and Optifast® are acceptable alternatives if done in
conjunction with the supervision of a physician or registered dietician and detailed documentation of
participation is available for review. However, physician-supervised programs consisting exclusively of
pharmacological management are not sufficient to meet this requirement.
• A thorough multidisciplinary evaluation within the previous six months which includes ALL of the
following:
an evaluation by a bariatric surgeon recommending surgical treatment, including a description of the
proposed procedure(s) and all of the associated Current Procedural Terminology (CPT) codes
a separate medical evaluation from a physician other than the requesting surgeon that includes a
recommendation for bariatric surgery
unequivocal clearance for bariatric surgery by a mental health provider
a nutritional evaluation by a physician or registered dietician
Here is a link to the current Cigna policy:
https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf
Hope this helps and good luck!

This is a violation of HIPAA. It may have been done mistakenly so I would contact the doctor's office and inform them.
I, like you, am a very private person and this probably wouldn't sit well with me either.

You can start now. I started the process with United Healthcare and hubby and I both changed jobs and our health insurance changed to Cigna. My timeframe changed from 6 months to 3 months. So instead of having surgery in Feb/March of next year, I'm going in on December 9th.
When we moved to Cigna, I called Cigna and got them to email me the criteria and verified benefits, co-pays, etc.
As far as nutrition, WW and Jenny Craig are acceptable as long as you are supervised by a medical doctor. Cigna does not require a day to day accounting of what your diet. The nutrition component is mostly to know you are equipped with the information to make you successful after the surgery. Monthly weigh-ins are also required. I visited my doctor's office once a month to be weighed. My surgeon has nutritionists in his practice so I used them for documentation. Please note: Cigna requires 90 days of documented nutrition information, not 89 but 90. I did 4 nutrition visits to be safe.
These are the Cigna requirements:
Medical management including evidence of active participation within the last 12 months in a weightmanagement
program that is supervised either by a physician or a registered dietician for a minimum of
three consecutive months ((i.e., ≥ 89 days). The weight-management program must include monthly
documentation of ALL of the following components:
weight
current dietary program
physical activity (e.g., exercise program)
Programs such as Weight Watchers®
, Jenny Craig® and Optifast® are acceptable alternatives if done in
conjunction with the supervision of a physician or registered dietician and detailed documentation of
participation is available for review. However, physician-supervised programs consisting exclusively of
pharmacological management are not sufficient to meet this requirement.
• A thorough multidisciplinary evaluation within the previous six months which includes ALL of the
following:
an evaluation by a bariatric surgeon recommending surgical treatment, including a description of the
proposed procedure(s) and all of the associated Current Procedural Terminology (CPT) codes
a separate medical evaluation from a physician other than the requesting surgeon that includes a
recommendation for bariatric surgery
unequivocal clearance for bariatric surgery by a mental health provider
a nutritional evaluation by a physician or registered dietician
Here is a link to the current Cigna policy:
https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf
Hope this helps and good luck!

This is a violation of HIPAA. It may have been done mistakenly so I would contact the doctor's office and inform them.
I, like you, am a very private person and this probably wouldn't sit well with me either.

@@Tobeornottobe - Hi All, I wanted to say that I was approved for surgery. The peer to peer review did come through.Thank God. I learned on Thursday. I faxed over some additional information that I thought would help. I don't know if that did the trick but 1/2 hour later, they called and said it was approved.

@@Solmar, sending positive vibes that all goes well with the peer to peer. Honestly, sometimes, the peer to peer does the trick. It maybe a small unanswered question the insurance company needs answered. This will all work out and you'll be ready to go in no time.