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And So It Begins...waiting On Insurance Approval



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Thank you. They are submitting additional documentation today so hopefully that will do it.

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I'm rooting for you!!

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Hey Jim! I think I know you... Same post on the LGH site ;) I think we are the only ones active over there. Lol they will get it straightened out. I am sure of it!

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Yep that's me. :) Nancy is working on it and told me not to worry she deals with this all the time. It might just take a bit longer.

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Jim,

Keep trying, wishing you the best of luck!

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Wow I am really bummed....

I got a call from the Center yesterday and they told me my Surgeon spoke directly with the doctor at Cigna and got shot down stating there is no medical necessity. Seriously? I know I am very healthy considering my 455 pound frame but c'mon!! I guess I need diabetes or high blood pressure to convince them? Or better yet a heart attack? but I may not survive that. I watched my father live through that and it wasn't pleasant.

Sorry for the rant and pity poor me party but I am just frustrated. I have done everything asked of me. I went to all the support classes and took a binge eaters 6 week support program. Changed my eating ways and dropped 32 pounds. I have passed all the preop testing with flying colors and was checked and probed by a 3rd party doctor who told me I have to be the healthiest overweight person he's ever met...

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U r 455 and they turned u down? U need to keep appealing with stats about obesity ie. joint break down, heart attacks (as u mentioned) sleep apnea etc. it's amazing u have normal numbers on ur blood work but u need to also state the great risk of diabetes, high bp and such. I'm sure I'm just repeating everything already running thru your mind but I used to collect from ins companies and I know that the squeaky wheel gets the grease!! Good luck and don't give up!!

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Oh yea...forgot to mention I do have sleep apnea. They know all that as well. I have gotten so used to sleeping with my CPAP that I sometimes forget why I have it. If that makes sense.

We are appealing. We are providing them more documentation along with food journals and exercise activity. Thankfully the Center I am working with is a great advocate. I was impressed that my actual surgeon took the time and made the call on my behalf and didn't staff it out. They're going above and beyond in my eyes.

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Oh Jim that it is just horrible! Considering you have sleep apnea, and clearly a family history since your dad had a heart attack, that is just unbelievable that Cigna is still denying. These insurance companies, I tell ya!

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Approved!!

Monday I was denied and this morning I got the call stating the approval is in. 5 months worth of food journals and exercise logs finally won them over. Thanks to all of you for mojo I really needed it. It's been a long week but now I am starting off the weekend with a bang!!

Surgery date is April 16 :rolleyes:

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Congrats! Finally the insurace company got it right. I hope everything goes smoothe with your surgery.

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Approved!!

Monday I was denied and this morning I got the call stating the approval is in. 5 months worth of food journals and exercise logs finally won them over. Thanks to all of you for mojo I really needed it. It's been a long week but now I am starting off the weekend with a bang!!

Surgery date is April 16 <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/rolleyes.gif' class='bbc_emoticon' alt=':rolleyes:' />

Congrats you are the day before me! We can do it!!!

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that's awesome news! congrats =)

healthygal73 ~ Sent from my iPad using LBT

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You & I are in the same boat. My paperwork was submitted on the 28th. I am a nervous wreck. Anxious, antsy, trouble sleeping.... this is as bad as waiting for my son to be born 22 yrs ago!!! My insurance is United Health Care/Secure Horizons AARP Medicare Advantage. They say it could take them 2 weeks - arggggggggg

Will be interesting to see which of us hears first.

Hugs,

Roni

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Congrats, Jim! I'm happy for you. :) After a difficult road to approval you must be relieved.

My doctor submitted me to insurance on the 28th as well. They said it will take two weeks to hear back. For the first time on this journey I am an emotional wreck. Irritable, anxious and barely sleeping (but also excited). Is this normal? Haha

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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      https://alluniqueguide.com/java-burn-coffee-reviews/
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