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Ashoryb

Gastric Sleeve Patients
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Posts posted by Ashoryb

  2. Posted

    @@Ashoryb they shouldn't be asking for all of that. Seems like they are going out of their way to be difficult. What they asked you for is not even a part of Cigna's requirements...smh

    They should have to answer for putting people through this mess!

    Sent from my SM-G925V using the BariatricPal App

    Thays what my doc was saying to. She said she has never had so many denials with needing such detailed information. She said they are probably MG hoping I will just give up. But I refuse

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    Forgot to mention that I'm definitely praying things work in your favor!

    Sent from my SM-G925V using the BariatricPal App

    Thank you so much prayers are much appriciated

    Sent from my SAMSUNG-SM-N900A using the BariatricPal App

  3. Posted

    Ok yall here's an update.

    I got my letter and they said they needed all the info on my previous failed lapband. It took some digging because the lapband I had was in 2008 removed in 2011. I did not even mention the band starting this process so not sure why they need all the info. They Arnt doing a revision so I didn't thunk it would be a big deal. They also said I gained one pound during my nut visits program which I did but it was during Thanksgiving and I lost the pound plus 6 more the next visit.

    Grr. So any who my doc resubmitted all my paperwork for the 3rd time now so please throw up a prayer and good thoughts. I'm trying not to lose hope. Hugs to you all

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  5. Posted

    I would call them back keep your foot on their neck. that is what i am doing now. i was denied the first time they said it was missing information so everything was done and my doc resubmitted last wednesday im still waiting if i get a denial again i am prepared with plan a plan b and plan c....they can tell you over the phone you ask the rep to talk to a manager immediately they cannot deny you that that is your insurance that YOU pay for..

    good luck hun.

    I'm so sorry you got denied as well. It's like a gut punch isn't it..... I hope yours turns into an approval. I was hoping mine wouldn't be am MMA fight but I'll give them that if that's what it takes

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  6. Posted

    My insurance wouldn't cover me at all. So I took came up with $ 4,300 and had the surgery in Mexico on 3/11/16. I needed a drastic change in my life and wasn't going to wait around insurance to cover me. Recovery hasn't been too bad, lots of liquids and Protein shakes so far. Looking forward to solid food but I know to wait until my stomach is ready to handle it. I started at 200, lost 7 on the pre op diet, just weighed myself and I am 182 :D:D :D . Oh my gosh it is working, cant wait to I get to my goal weight. If you can afford it, go to Mexico for surgery. I was treated very well.

    Congrats on getting your surgery! I wish I could afford to go to Mexico for real. Keep me updated on how your doing

    Sent from my SAMSUNG-SM-N900A using the BariatricPal App

  7. Posted

    Just some info. that might help. Most insurance companies have people who just review cases for approval. What they don't want you to know is that most of these people have either no medical background or if they are doctors they are not bariatric specialists. Now tell me what sense is it to have a dermatologist reviewing cases for wls?? So call your insurance company and ask them who reviewed your case and what their credentials and qualifications are. They will tell you some type of specialist doctor. If it is not a bariatric specialist request one. But most of the time they don't want to tell you because it's not a doctor at all. It is just some random person like you and me. Be forceful and do not take no for an answer! You want your case reviewed by a wls doctor! I would be very surprised if you didn't get approved... good luck! I hope this helps!!!

    Sent from my SM-T350 using the BariatricPal App

    Thank you so much I will Def call them and get a Wls specialist to look it over. I wish I did have the money to go to Mexico but I dont. I will keep bugging them because I believe a weightloss specialist will see that I have medical necessity. Thanks yall for all your awesome advice I needed to vent to people who understand

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  8. Posted

    You also can inform CIGNA that you are filing a complaint with the insurance commissioner.

    That's a great idea I will Def do that!! Dee my insurance is with cigna but through a third party for businesses called group administrators. So they are the ones being so crazy

    Sent from my SAMSUNG-SM-N900A using the BariatricPal App

    I have heard that most cases from my surgeons office have been approved after appeal. It is terrible that they make you "wait for the denial letter" to learn why they are saying no! I agree, get on the phone. As long as you meet the criteria, I would ask for a one on one between your surgeon and Cigna's Medical Director. Don't back down if you know it should be covered.

    Good luck!

    I def won't back down. This is literally life for me so I'm gonna do whatever I can until the bitter end

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  9. Posted

    No you don't sound like a drama queen. I know how hard it was for me to just wait on a response from them for approval and can't even begin to tell you how I would have taken it if they came back with a denial. You've done everything you're supposed to do and your feelings are justified. It makes no sense they wouldn't tell you why though. Try going over the reps head to speak with a manager.

    If you don't mind me asking, what did they saythey denied you for the last time?

    The first time I was denied it was because the wanted me to get pulmonary clearance and blood work. I did all that re submitted. But again denial. Thanks so much for understanding l. I almost broke down into tears at work

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  10. Posted

    I'm so sorry to hear that. Call and ask questions. Then contact your surgeon's office. I didn't get an answer until I started getting on people's nerves. It took longer than expected but I finally got that approval and believe you will too!

    Sent from my SM-G925V using the BariatricPal App

    I called my surgeons office and they said they would take it to the next level. I also Called my hr department as well and told then I need their help. I've just gotta calm down. I'm just so hurt

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    I know I sound like a drama queen but I've done everything.

    Sent from my SAMSUNG-SM-N900A using the BariatricPal App

  17. Posted

    Insurances are all different. My first submission to Cigna was denied based on a stupid misunderstanding of 3 months vs 89+ days. Cigna says it has 15 business days to make a decision. I received my approval on the 15th day. You haven't hit your 15 days yet , so I wouldn't worry.

    Best of Luck to you.

    Sent from my iPad using the BariatricPal App

    Oh ugh! Buisness days. I was counting every day that's makes me feel a bit better. I'm just excited and I'm ready for this change. Thanks yall for responding

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  18. Posted

    Ok so I got denied my first time submitting to insurance because although I have a bmi of 53 ans I did all the nut visits psych cardiac and sono the said I needed pulmonary clearance blood work and info on my band procedure and removal..

    Got all that and resubmitted with everything they asked in march 1st 2016 and still no word. Grr I keep reading about how people got approved in days or even hours and I'm just in lala land. I've called 3 times and it's in Peer review so I don't know what all that consists of. Just so frustrated. Sorry just needed to vent.

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  19. Posted

    @@Sarah 82...I have Cigna insurance and they confirm they received my paperwork on March 2nd but I'm still pending. Almost all the post I've read about Cigna say they were approved in about 2 days. Is the fact that I'm going on week 2 and still pending a bad sign? When I called, they said it was being reviewed by a nurse and would then be reviewed by the medical director.

    I also have cigna. The first time I submitted they came back with with a denial in less than two weeks. They added some more tests and I finished those and re submitted on March 1st. Still no word so I totally understand what your saying. All these others getting approval so fast and for us it's taking forever :(

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  20. Posted

    I don't have a date yet. I'm approved but Melissa is my insurance specialist and I can't get her to get it done. (Long story)

    Anyway, if I don't take my approval elsewhere, I will be at Baylor trophy club. I never heard of the Destiny center. Sounds nice. I only went to Frisco twice. All my other appintments were in Colleyville. I'm glad it went well for you :)

    I'm so glad I saw your post!! She's my "specialist" to and it's been like pulling teeth. I've been very frustrated with her for a while now. Sorry is know this is an old post but I just had to comment

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  24. Posted

    @@Ashoryb I hope you hear soon! You are really dedicated to your health and this process so even if they give you more hoops to jump through it will suck but you will make it and reach your goals I have no doubt!

    Your hope about your future and willingness to reach out will fuel your success. Best of luck to you.

    Butterfly 23 Thank you so much for your reply. I appriciate your kind words. I'm very dedicated to this process because I have a beautiful 3 year old daughter who needs a mom thay can play with her. All I can do is sit and watch. My insurance is cigna but goes through a third party call group administrators and they are ruthless. But I can be pretty ruthless myself :)

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  25. Posted

    Good evening,

    My name is Ashley and I'm newbie here. I never thought about joining a bariatric support group. But I do believe this will help me considering how frustrating my journey has been up until now periods I started my journey August of 2015 and I'm going to be using dr. Kim in Texas. I came into this knowing that my insurance which happens to be Cigna is very strict. I have a 53 BMI , obstructive sleep apnea, PCOS, and chronic back pain. I found the support group while I was maniacally searching 4 people experiencing the same things that I am experiencing. My insurance required three months of nutritionist verified diet psychological evaluation cardiac clearance as well as cardiac sonogram. I got all that done and submitted all my stuff to Insurance on January 14th of 2016. Cigna denied me on the 25th of January 2016 because they said I needed pulmonary clearance as well as blood work and they said they did not receive my cardiac testing clearance. Now I've gotten all that done and I just resubmitted March 1st of 2016 and now its March 11th of 2016 and I still have not heard anything. So I started searching for people who have been in the same boat as me and I found this wonderful support group and I've been reading a lot of your stories and experiences and I know by being in this group it would give me some comfort I wish I had found this when I first started. My starting BMI is 53 my starting weight is 320 and I'm so hopeful about my future. I have had a failed lap band which I got banded it in 2008 and then band removal in 2011. Gastric sleeve is a dream come true if I can ever get the approval. I know this has been long but I really wanted to introduce myself so that if anyone has a story like mine they can share with me so that I know I'm not alone.

    Sent from my SAMSUNG-SM-N900A using the BariatricPal App

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