LessFee

How small is this practice? I only ask because usually, the doctor/doctors have no idea what’s going on with the front of house. They count on the practice manager to run the office and fulfill records requests. The manager has probably heard that you’ve been calling and is holding up your records. Before I took over, our old manager used to do that, too. It looks like you’re in good shape to get duplicates of what you submitted. That’s great! Just have those items sent over to a new doc, and they can write a new letter of medical necessity to get you reapproved with them if you want. Just a heads up for the future: it’s always a good idea to create your own medical record. Anything you submit to a doctor or to your job regarding your healthcare (FMLA papers and such) should either be a copy, or if they require an original, you should keep a copy for yourself. If you see multiple doctors, you can keep different folders for each, or you can just have one big folder; whatever makes sense to you. This way, you have a bit more control over your paperwork!

I will say, as a person who used to work in a doctor’s office, that HIPAA allows for 30 days to send records. They probably know that and are just being salty by taking their sweet time. Definitely send the certified written request for the records. I know you want to get the surgery done, but just think, you’ll have post-op visits at this place, and you’ll have to deal with them for a while. Do you really want that knowing they have horrible customer service? Best of luck to you!

I had my pre-op appointment today! I got my labs, EKG, and chest x-ray done. I also got my pre-op diet, post op diet, and surgery instructions. I start pre-op diet on 7/10, and surgery is 7/24. It’s finally starting to feel real!!

Congratulations!!! That’s so exciting!!

I can’t believe they do that! It seems so mean! I’m sorry.

Red and orange are usually a “no-no” because if you vomit, or they’re observing your insides, they don’t want to be thinking it’s blood. Which is why, if you notice, hospitals usually only have green or yellow Jello. Even though they didn’t specify, I’d avoid red stuff anyway just to be nice and to avoid any possible/additional unnecessary testing/complications.

Nursing student here! If you have known issues with your kidneys, this could be an expected result. Your kidneys secrete HCO3 which is a base. It helps maintain the acid-base balance in your body. In this result, the pCO2 is more basic to compensate for the fact that the kidneys are not secreting enough HCO3 (bicarbonate). If you don’t have kidney problems, I’m not by any means telling you that you do. I’m just saying that for whatever reason, your bicarbonate was low, so your PCO2 being more basic (less than 35) is a compensatory mechanism. Honestly, I’d think a PCO2 on the higher side would be a problem for surgery. That means you’d have a problem with ventilation (45+ is more acidic) and were retaining CO2 which would be a problem for anesthesia. I don’t think you have anything to worry about!

VSG July 24th!

Thanks! I finally caught up with the scheduler today! I’m scheduled for 07/24! So excited!!

Hopefully you can get that worked out soon! Good luck to you!

I didn’t do a medically supervised diet either! Cigna doesn’t require one, and my surgeon only requires what the insurance requires. My PCP just wrote in her letter all of the things that I did try. That seemed to work just fine! Try not to count yourself out! I know you want the DS, but is there any way you could just do the VSG or RnY and go with Dr. Henke? His office is great!

I feel like these offices are telling you this because the office is low-key requiring it to make sure you get approved. When Cigna approves you (or denies you) they send out a letter that details the exact requirements for approval. Nowhere in there is there mention of a diet. This is weird.

That is so weird. Scott, the coordinator at Dr. Henke’s office, is great! He emails you the requirements and goes over them with you before your first appointment. One of the first things he said was that Cigna didn't require a diet, and you only had to have one nutrition consult (which was true). And the letter from my doctor was really generic. She just said that I tried Weight Watchers, Atkins, and we had discussed my weight at her office. I definitely expected more hoops, but I didn’t get any!

I should clarify that I was approved for VSG! Sorry if that confused you! That said, is it that DS isn’t covered at all? Or is it that it’s excluded by your plan?

Nope. Cigna only has those 4 requirements that I mentioned above. There is no 6-month requirement or medically-supervised diet requirement of any kind at this time. The current requirements are good through July, so it may change after that. But for now, I was approved submitting the 4 items I listed above per Cigna’s current policy.

I’m in Dallas, and I’m using Dr. Jeffrey Henke. His office is great. Before your appointment with him, they send you a copy of the requirements for surgery that are specific to your insurance. I had the psych appointment booked before I even saw him.

Hey there! I just got approved by Cigna this week! Their requirements are: a recommendation from a nutritionist, a psych recommendation, a recommendation from the surgeon, and a recommendation from a physician who is not the surgeon nor is affiliated with the surgeon (my PCP provided this). Cigna does not have specific requirements for a medically-supervised diet, and I did not do one. That said, I have heard of PCPs/surgeons not giving you a recommendation until you meet a requirement that they have, but Cigna does not have a physician-supervised diet requirement as of right now. As soon as my surgeon’s office received those 4 things, it was sent off and my surgery was approved within 4 days. The whole process took a few weeks but only because of my schedule and having to move appointments around. I hope that helps!! Good luck!