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ldawn

Pre Op
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Everything posted by ldawn

  1. I complained to the office manager yesterday about them not submitting to my insurance yet. So she submitted today. But wait.....there’s more! I am still having issues w Cigna. When I first started out in early october Cigna quoted my surgeon’s office wrong info. After an hour on the phone w Cigna they figured out that whoever set me up put me on the wrong plan. I work for the hospital who will be doing my surgery. Hospitals offer better coverage if you do you surgeries through them. They didn’t put me on the hospital plan. So fast forward to today. They kept telling surgeon’s office that I had to go to a different city for my surgery. Turns out when they fixed my insurance plan they put me on w a different hospital within our system. SMH. It’s all fixed now. Just waiting approval.
  2. What also frustrates me is that I left her 2 messages last week but she didn’t return my calls. And whenever I call it always takes 2 tries (once it took 3) because the first time she picks up the phone and hangs up immediately. When you call back you get the voicemail. Today I spoke w the office manager. She said she will call me at 9 am tomorrow after she speaks w her (because of course she is off today).
  3. Girl I’m in the same boat. At my surgeon’s appt 2 weeks ago he said they would be submitting. Said it would be a week to get it all together and to insurance. Then insurance is 72 hours. They haven’t even submitted yet!! So annoyed.
  4. ldawn

    Tell Me Your Pre-op Timeline

    I didn’t realize I could view it on my Cigna!! I just checked and mine isn’t there yet. Boo!
  5. ldawn

    Tell Me Your Pre-op Timeline

    I have Cigna. They don’t require any monitored diet. My surgeon required 2 nutrition visits, Cigna just wanted 1.
  6. ldawn

    Tell Me Your Pre-op Timeline

    September-appt w PCP to get recommendation for surgery Oct 2-seminar Oct 4- 1st appt w surgeon October 8-bloodwork and ekg October 17- nutrition visit #1 Nov 2- egd Nov 10- psych Nov 14- nutrition visit #2 Nov 26- surgeon visit #2 and submit for insurance approval. Now just waiting on insurance. I had a sleep study done in the past year, otherwise I would have needed one of those as well.
  7. ldawn

    Your Teeth After Surgery

    I am anticipating RNY in January. I had a dentist appt yesterday and asked about my dental health after surgery. They don’t anticipate any issues. Just said to take my vitamins.
  8. Just remember what insurance was billed means absolutely nothing. Those are contracted and the hospital in no way expects to get that money. Self pay has a much lower price. My friends who went to Mexico paid $4K
  9. Unjury’s website has a lot of recipes. Check those out.
  10. Home sleep studies are good. But there may be additional requirements. Depending on the company, you will wear them 1-3 nights. After they receive it back it takes 3-7 days for the doctor to receive a report. If the report shows severe sleep apnea there may be additional requirements. The auto cpap is very popular. It has automatic settings. But severe sleep apnea usually requires higher setting that the auto cpap can accommodate. This is where you May have to have a second in house study for determining the appropriate settings for you. There are no home type machines for this test. Your surgeon may also require you to wear the cpap for a month before having surgery. And just so you know, they can request a 30 day report from the cpap company. It tells how many nights you wear it and for how many hours. In general, compliance is considered wearing it 70% of nights for at least 4 hours. Some doctors will let you have the auto cpap even w severe sleep apnea. I have severe sleep apnea and have an automatic.
  11. ldawn

    1 year Post Op (BUT ISSUES...)

    You look amazing! And very happy! Please don’t forget electrolytes have the ability to kill you. Potassium has a direct effect on the heart muscle and if there is a severe excess or deficiency it can cause cardiac arrest. We need you around a long time. Take your vitamins!
  12. The last hospital I worked for didn’t cover it. Then would have administrative meetings to discuss insurance costs and complain about how much certain people were spending. It was crazy. It was like 60% of insurance claims were from 9 people. Each was morbidly obese. Well, maybe if you would cover the surgery they may not have all these health issues. The hospital I currently work for does cover it, but only if you have it done at our facility and with our surgeon. And since it’s being done at our facility there is no deductible, just the 15% coinsurance.
  13. Let me tell you what happened yesterday. A little background...I work for a hospital. I’m also a very new employee here and recently read my summary of benefits and already had an idea of what my expected payment would be. One of the features of my insurance is that if I have surgery (or anything) at my facility with a staff doctor then there is no deductible and my copay is 15% for surgery and $35 for specialist office visit. I made my first surgeon consult appt for Thursday. I get a call yesterday from their insurance specialist about my benefits/expected payment. She said my insurance has a special $2000 deductible for bariatric surgery that applies to the surgery and all office visits related to the surgery. My consult will be $226 and I will have to pay full amount for everything until the deductible is met then my 15% copay of the surgery. I was shocked. I went home and pulled up my summary of benefits and reread it. This morning I spent an hour on the phone w Cigna. They initially told me the exact same info the insurance specialist had been told. I explained what I found in my summary of benefits. She was able to see my summary of benefits herself and said my actual policy did not match it. She ended up calling the person at Cigna who is the main rep for my hospital system. Turns out, someone had chosen the wrong selection when putting the package together in their system. My information was correct. No deductible required. They will correct it issue in a few days. I work for a very large hospital system. I asked the Cigna rep what about people who already had their surgery this year and paid the deductible? She said she didn’t know what would happen. I then called the insurance specialist at my surgeon’s office and told her the story. She said they see a lot of people from the hospital. She also doubts the hospital will refund any money to them. So, know your benefits. Do your own research. Don’t be afraid to ask questions. It may save you a lot of money. It could also be the difference between having the procedure or not.

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