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Fighting the urge to give up on my surgery



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I'm lucky enough that my insurance company covers my surgery and I've saved up enough to cover most of the other out of pocket expenses - we try to be tight financially so this is a big deal for us. I would never have been able to do this if it wasn't for insurance and I've been so excited since I've started my journey. I have completed my six months of diet and exercise, done my pych eval, all the pre op testing, five years of weight history, everything I need to do. Initially I was hoping to have my surgery completed a couple weeks ago. My hold up - for the past six weeks my PCP's office and my surgeons office can't connect all my paperwork from the diet and exercise in order to submit to insurance. I'm getting sooo frustrated mostly at my surgeons office. They don't return my phone calls, seem unorganized and two weeks ago someone told me they had submitted my paperwork to Cigna and when I called again to check on it (because no one returned my messages) they tell me again they are still waiting on some of my diet and exercise paperwork and never submitted to insurance. Which when I call my PCP's office they insist all has been sent. So I feel like I'm in limbo, that this is never going to happen. And frankly I wouldn't mind starting at another surgeons office but I'm too cheap - I'd loose out on the $500 I've already spent. = (

I guess I just wanted to vent and see if anyone else had a similar problem.

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I had my first surgical consult on Thursday. I was relaly early because it was a fairly long drive, so I sat in the waiting room and listened to the insurance lady talking to the "patient coordinator" lady and OMG, the patient coordinator was pretty unorganized. I had everything ready for her, I even made copies of my driver's license and insurance card for her and as I was leaving she STILL asked if I was self pay. I have no idea if she submitted my file to the insurance person or not.

I can already tell I'm going ot have to follow up every step of the way.

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My insurance is with Cigna, and they were good. The holdup I had---for about 2 extra weeks was paperwork not being submitted from my surgeon's office. That had to be faxed. It all worked out fine but I was denied coverage from Cigna-----that letter jolted me, and it was an oversight from the surgeon's office with one missing document. Once I have my surgery----3 weeks after all was approved----I'll speak with someone about the snafus. I had been forewarned by another patient! And Cigna was just okay-----one call I got someone quite terrible and the second call was a wonderfully efficient person. Follow-up both, I say! Good luck to you!

I'm lucky enough that my insurance company covers my surgery and I've saved up enough to cover most of the other out of pocket expenses - we try to be tight financially so this is a big deal for us. I would never have been able to do this if it wasn't for insurance and I've been so excited since I've started my journey. I have completed my six months of diet and exercise, done my pych eval, all the pre op testing, five years of weight history, everything I need to do. Initially I was hoping to have my surgery completed a couple weeks ago. My hold up - for the past six weeks my PCP's office and my surgeons office can't connect all my paperwork from the diet and exercise in order to submit to insurance. I'm getting sooo frustrated mostly at my surgeons office. They don't return my phone calls, seem unorganized and two weeks ago someone told me they had submitted my paperwork to Cigna and when I called again to check on it (because no one returned my messages) they tell me again they are still waiting on some of my diet and exercise paperwork and never submitted to insurance. Which when I call my PCP's office they insist all has been sent. So I feel like I'm in limbo, that this is never going to happen. And frankly I wouldn't mind starting at another surgeons office but I'm too cheap - I'd loose out on the $500 I've already spent. = (

I guess I just wanted to vent and see if anyone else had a similar problem.

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sounds very familiar, which Surgeon do you have, if you dont mind me asking..just curious if it is the same one or if they are all the same. I would send a fax and call and leave messages to find out if they got it, b/c the first fax sat on their desk for two weeks..ugh

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sounds very familiar, which Surgeon do you have, if you dont mind me asking..just curious if it is the same one or if they are all the same. I would send a fax and call and leave messages to find out if they got it, b/c the first fax sat on their desk for two weeks..ugh

I'm using one of the Weight Loss institutes in Arizona - they do primarily Lap Band and initally that's what I was interested in until I did more research. I wish now I had went with someone else but hopefully as long as good things come out of my sistuation it will be all good. = )

Still waiting. = )

Christie

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I'm using one of the Weight Loss institutes in Arizona - they do primarily Lap Band and initally that's what I was interested in until I did more research. I wish now I had went with someone else but hopefully as long as good things come out of my sistuation it will be all good. = )

Still waiting. = )

Christie

I would go to the PCP and get copies of all your paper work, make a spare copy and then personally hand the paper work to the office manager only and tell her how long you have been waiting. I would then ask her if she thinks it is still going to be a problem or should you look for another surgeon.

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WOW - i read that and thought you must be going to the same one i am here in MO. I called my insurance at the beginning of last week and they said I was approved and have sent two letters to dr stating that- but girl at the office says they havn't gotten anything and can not schedule my surgery till she gets the papers- OMGoodness! I am going crazy- My insurance says they have sent it twice now- very frustrating to know that the only thing that is keeping you from having surgery is some one who does not know how to do their job- plus- like you the office I go to most ly does lap band- and even tho on everything I wrote I wanted the sleeve done- she turned it in to insurance over a month ago- but come to find out- for the BAND not the sleeve- so she had to resubmit everything the beginning of March and now I am approved but can't get her to schedule the surgery - and to think if she actually knew how to do her job I could have been sleeved over a month ago!! - UGH!!!! I so understand your frustration!

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It must be really aggravating to get stalled when you're all psyched to go and others' incompetence is holding you back. It sure would try my patience. But I'll bet you a Protein Shake that a year from now when you look back at how wonderfully your life has changed, it won't matter very much that you got started 2 or 4 weeks later than you planned.

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I agree 100% with Myrori in her reply above. I personally delivered a lot of the paperwork from my PCP to my surgeons office because it got delayed the 1st time, and I was not going to stand for that again. I would have my PCP do the paperwork, give me copies, I would then take the copies home, and fax them directly to the surgeons office, then call to make sure they received the fax. Dont give up on the process, just work through it, you'll be happy you did!

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It must be really aggravating to get stalled when you're all psyched to go and others' incompetence is holding you back. It sure would try my patience. But I'll bet you a Protein shake that a year from now when you look back at how wonderfully your life has changed, it won't matter very much that you got started 2 or 4 weeks later than you planned.

Good answer!! keep your eye on the prize right!!:rolleyes:

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Cigna is pretty quick with approval once they have EVERYTHING.

I was denied, and was NOT looking forward to the appeal process as I had a specific date that I NEEDED my surgery on in order to get the time off.

Once I submitted the information to the additional information department, I had my PRE approval in a day, (Friday) and my REAL approval that Monday.

So hopefully your surgeon's office will get it together and get the ball rolling!

Good luck!

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Mostly my frustration was I think that my PCP's office (from what they told me) had really sent all they needed too - 45 pages worth but my surgeons office wasn't asking any questions to make sure that's what they needed. And my specific PCP's last day at the practice is tomorrow. I've had this in mind that I had plenty of time if we needed to get anything still from her before she left the practice since my last date of the six month diet and exercise w/ her was six weeks ago.

On my plus non-whiney note - I just called again to my surgeons office and they said they received the last of what they needed this morning (??) and would submit this week. Wish me luck! As some of you awesome ladies said - a year from now this will be a distant memory and will make no difference. = ) I appreciate the encouragement!

Thanks!

Christie

"Just keep swimming, just keep swimming, just keep swimming swimming swimming."

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