Odee

Thank you all ! I am very excited. I can hardly contain myself at work today, I want to scream !!!!! I am also a little bit nervous now that its all coming together. So many things to worry about regarding the surgery... Right now I just want to enjoy this feeling cause it sure is nice !!

ONCE all the requirements were met to Cigna's satisfaction (Friday), I was approved today (Monday). But, we went several weeks back and forth with Cigna on technicalities. I was denied twice and then had to have a Peer to Peer. Cigna was a real stickler, believe it or not, on the letter from my primary care physician. Good luck to you, I'm sure all will go smoothly for you. A word of advice, make sure the letter clearly states that you are "cleared for surgery". My PCP did 2 letters that were rejected but we got it right the 3rd time(always a charm). Odee

The coordinator just called and let me know that I was approved!!! She said she had a bunch of people waiting for her with appointments etc. but she wanted to let me know that the approval went through and she would be calling me back later to schedule the surgery etc. So excited, just had to share! :D :D :D :D Odee

You look marvelous !

That's why I was so surprised about the letter problem. I've seen posts on here where others have said Cigna is very specific about the wording in the letter. Why wouldn't the office know this and why would they twice submit the letter when it was incomplete. Thanks ladies for the encouragement. Much needed.

I was denied because the letter from my doctor did not clearly state "I was CLEARED for surgery". Totally bogus because my doctor basically said that twenty different ways but Cigna wanted exactly those words. This has happened twice and now they want the peer to peer. The coordinator was very bleak about it. I feel terrible because these are just incidental issues they are getting hung up on and more so, I am frustrated with the surgeon's office for not being on top of the requirements. Very depressing to go this far and get stopped over a technicality and the surgeon's coordinator laugh's it off saying "well you can always appeal, you know how insurance companies are". Maybe I am just being overly sensitive because I'm so far into the process and feel like I've put my heart and soul into it.

No one had to have the "peer to peer" ????

I am so frustrated with Cigna and with my surgeon's office !!!!!! OK, let me calm down. What should I expect from the *peer to peer* that Cigna is requesting? This whole process has been so frustrating and upsetting, right now I literally feel like I've been punched in the gut. Sorry for the dramatics, its just one of those days for me today - not just this but everything is going wrong today. Can anyone offer any advise on the peer to peer? Also, has anyone had to do a formal appeal and won? My surgeon's office said if the peer to peer doesn't work, I am on my own to file an appeal. Ughhhhhhh!!! I feel like I've been on my own the whole time dealing with Cigna. Sorry for the venting. Thanks !

Thank you all for your support and kind words. I can't say thank you enough! I was really feeling down. I know more than I did a few hours ago and feel optimistic. Feeling much better ! =) Thanks Ladies!

So, Cigna is claiming they still need a letter from my doctor that says I am CLEAR for surgery. My doctor has sent over 3 letters that all say variations of this yet they are not accepting the letters. Now Cigna says there has to be a peer to peer consultation. My surgeon's coordinator said she doubts the surgeon will do it and we'll have to appeal. Anyone have to have this peer to peer and why would the surgeon not do it. She made it seem like he doesn't have the time. Again, very disappointed especially since I did complete all the requested requirements. Cigna is definitely playing games and it is very frustrating ! Thanks for letting me vent ! Odee

Thanks ! I feel better now =) Knowledge is power ! Odee

So I just found out that Cigna denied my claim. My coordinator said we'll just try again after resubmitting. I feel like I was kicked in the stomach ! They said the PCP letter and co-morbidity were missing and the consultation with the nutritionalist. The PCP letter and co-morbidity information was not omitted so I am not sure why they are claiming that in the denial. The consultation with the nutritionalist was missing however. I have that appointment tomorrow at 11 AM. The coordinator said she's been super busy and didn't realize I hadn't had the consultation yet and apologized. Why would Cigna claim to not have received the letters ? Just frustrating to get this far and then get denied so quickly. Just wanted to vent ! Thanks for listening ! Odee

Hello all, I thought I was well prepared for all of my pre-op requirements but my coordinator just called and said she can't believe she forgot to have me do the "ketosis diet". I have to go there for an appointment tomorrow at 11 AM. Can anyone fill me in on what to expect and is this a normal insurance requirement ? Thanks in advance ! Odee

Positive vibes coming your way !

Thanks for sharing ! I am pre-op and really appreciate and enjoy when you guys share your experiences. Your added humor was a plus !!! Congratulations =)

Congratulations ! What a blessing.

Hi everyone ! I don't have my date yet but hopefully will SOON! My surgeons office said all they are waiting on is a letter from my primary doctor that he endorses the surgery and one from my Rheumatologist would be nice too. My question is do you write the letter for the doctor and have them sign it or do they write their own letters? My surgeons coordinator gave me the fax number and said " have them send it to this number". I will call her tomorrow for clarification, i was just curious if anyone had any advise on this subject. Thanks !! Odee

Congratulations ! Best wishes !!! I can't wait for the day when I can say the same

Now that I am getting closer to submit for insurance approval it has dawned on me that there is a good chance I could actually get denied. Up until now I've been assuming I would be approved and now today it hit me like a brick, that there is the chance I get denied - nothing is guaranteed no matter what the office coordinator may "think". I guess its normal and just nerves. The ulcers have pushed my date out twice already and I go Thursday for *fingers crossed* my last endoscopy. After that, all me pre requirements have been met. I'm nervous and I hate this feeling !!!! Ughhhhhh - but thank you for letting me vent Odee

GOOD LUCK !!!!

Awesome, thanks all !

I think the only way I will be able to handle it is because I HAVE to. Its one of those things. When you have no choice, you have no choice and have to handle appropriately. I know with the surgery there is no way around it and I look forward to that. Right now I am thinking of and writing down hobbies I need to take up besides eating !

I am very bored today, I guess I should be happy that I had no obligations or tasks to handle today but now mid afternoon I am bored to tears. I am fighting myself with eating big time today. I know I am not physically hungry and that got me to thinking. I don't remember the last time that I actually ate because I was physically hungry. True hunger. I read a lot in forums how people talk about forgetting to eat and never being hungry anymore and I think, jeez I am never hungry but sure eat a lot ! Same goes for eating until you are full. It takes a lot for me to feel fullness. Long story short, what have you learned to do to conquer the mindless eating or non hunger eating. I'm journaling today and that is helping a little bit. I will hopefully be sleeved in June and want to be as prepared as I can be for the wake up call that I actually will need to eat for health reasons and to take care of my self and body and not just because. Thanks for any insight and feedback on this ! Odee

You have to order from his website - $9.99. Then you will download the book - THEN you need to drop the book into your iTunes account and THEN you can sync with you iPad or iPhone. It was really easier than I thought when I read the directions. They also have a Nook and Kindle version. You can also buy the regular paper book and have it shipped to you. Let me know if you have any trouble ordering it and I can help ! Odee

I read a LOT of it last night after I ordered it (iPad). VERY informative, he spells out exactly what to DO and what NOT to do. I recommend it.