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Shelby

LAP-BAND Patients
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Posts posted by Shelby


  1. Hi All - I was banded on Tues 8/28 and still have alot of pain in the port area. The only relief I get from the pain is when I'm laying down in bed. Sitting and standing hurt sooo much. I'm going back to work on Tues 9/4 (desk job - lots of sitting/standing) and I'm freaking out! I'm keeping up with the pain meds but that doesn't seem to help much.

    Should the port pain last this long and be this intense?


  2. Hi Bigez1, my policy does covers WLS so my battle will be different from yours. Cigna just kept saying no and I was forced to appeal.

    From what I read here on this site - winning an appeal when there is no WLS coverage/rider is not too hopeful. But keep reading these posts - I know I have read someone recommending what one can do in this case. I'll see if I can find them....

    Good Luck!


  3. Cindy - this is great news!! Congratulations on all your testings! I'm sure it's such a relief that it's over. Sept 12 - fantastic!

    I have good news too - I've been approved!!! Cigna's legal counsel called my atty to say I was approved. Legal never calls on approval - we're assuming they received my paperwork the first time she sent it and they have 30 business days legally to approve/deny - at that point it was over 60. I'm just happy I'm approved.

    Right now I'm waiting on a call back from my doctors office - need to schedule the pre-op testing. What type of pre-op tests did you have to complete?

    Congratulations again!


  4. Thanks Big Fred and Sweethot143! I'm still so excited!

    Big Fred hang in there - my advice to you (I know you didn't ask but from my experiences) regarding your 6 month PCP visits - make sure your doctor documents your weight and discussion re diet and exercise. Cigna does comb thru these notes. Oh and never give up!

    Thanks again and best of luck to the both of you!


  5. I work with alot of people and only 2 friends at work know of my journey and are very supportive. I will tell my boss I'm having a procedure but will not tell him the details (legally he can't ask). And I will tell everyone else that I'm taking vacation and ask for his support in telling folks I'm on vacation if asked. When my band and I have some time to get better acquaited I'm sure I'll be happy to share my story. But for now - this works for me.


  6. I totally understand Heyhon63 but there is really no getting around the 6 month supervised PCP visits with Cigna. It will be done before you know it. Just make sure your PCP writes down your weight each month and notes regarding your diet & exercise discussions.

    Good Luck to you!


  7. My case is with the National Appeals Unit (I have Cigna) and Walter & Kelley Lindstrom have been helping me with this. Kelley is anticipating a denial (based on her experiences). The next step would be an Appeal Hearing. Has anyone gone this far in the appeal process? I know I would have to attend but not sure what to expect. The Lindstroms will advise me but since they are in CA and I live in TX I'll be attending this alone. Has anyone attended one of these?


  8. This is a great place to ask questions! My first denial was because the surgeons office submitted my paperwork before I completed all of Cigna's requirements (yup!). So that was a no-brainer denial. I was denied the 2nd time for the Gastric ByPass surgery - yeah - scrary huh? When I called Cigna regarding this they said I should not have followed the instructions on the 1st deniel letter and included the letter. Who knew? Then I found a new surgeon and they submitted everything to Cigna (w/o denial letters) but was denied because of something to do with my 6 month doc visits. I say 'something' because I received a 2 page letter that I just could not understand! Seriously - when I called Cigna they couldn't explain it to me either! And that time I actually talked to 4 people and no one could explain it! They suggested my surgeron and their Director of Medicine talk about my case. My surgeon called 4 times before he gave up. He was never able to reach the Director of Medicine. He was told he was given the wrong number to call, was put on hold for 20 mins at a time, etc. I was then referred to Walter Lindstrom who accepted my case and I'm now waiting for him to submitt an appeal.

    Sorry so long winded - it's just so frustrating when it all seems to be administrative issues. I meet the criteria, I've completed what was required by Cigna, my policy covers Lapband (no exclusions). It's just crazy! Guess Cigna is hoping I'll go away but I'm not!

    Hang in there! Keep calling. If you get a rep that is not so helpful - hang up and call back. I was only told the reason of denial after the denial letter had been mailed to me. Guess that way I'd have to re-submit and wait an additional 30 business days. Just my guess.

    I hope I didn't scare or discourage you! Keep the faith! What's meant for us won't go by us!


  9. Congratulations Wanabethin!!! I'm very excited for you! Do you have a surgery date yet? Who is your surgeron?

    My Update: Cigna gave my surgeron the run-around and they never connected via phone. The office referred me to Walter Lindstrom (ObesityHelp.com Atty) and he has accepted my case! Walter will submitt the paperwork for an appeal. He doesn't take any cases he can't win so hopefully he'll be able to help me! I'm so grateful for his help.

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