Hi All!

So i am still in my pre-op, insurance requirements phase, which is long and annoying in itself..lol. I have Cigna, and they require a 3 month pre op supervised diet with a nutritionist, I have only one more visit before they can submit to my insurance.

So i have been working really hard at getting all of my pre-op appointments/tests completed before my last NUT visit, which is April 10th. I have been in contact with my surgeons office, and LUCKY ME, they have a brand new coordinator there. I spoke to her for the first time a couple of weeks ago, and let her know that i am definitely ready for surgery (i made my decision back in November) and I want to have everything done before April 10th so that they can submit to my insurance and I can get my date.. at that time she stated that I could possibly have a date of April 13th, I thought that was very strange, because i need my insurance approved first, but it got my hopes up a little.

I have completed all of my bloodwork and tests, and called yesterday just to ask some general questions about when i can have a pre-op appointment, and if it can be before the last nut visit, and also if they will submit to my insurance immediately. I really need to know for work purposes, and also I have a lot of social obligations in April, and May (christenings, parties, communions, baby showers, and weddings) i just want to be sure that if i can't attend i will give enough notice. I think that she may have been having a bad day, because she stated i was still missing things that she had confirmed were done on our last call. Then she said well nothing is going to be done with this until you are closer to being done with your NUT visits, so I can't tell you anything. I only have 1 left and it is on April 10th, so she rushed me off the phone and said i need to complete my requirements, and call closer to my date of being completed. Hmmmm, Now i feel bad calling again today, after re - faxing everything i had already faxed over. I don't mean to be pushy, I am just ready, and want to do this as soon as I can... Sorry to vent guys!!

I understand. I started in April of last year and had surgery scheduled in July. Then changed jobs. The new job didn't cover surgery. In January we changed insurance and I was back on but had to start over. Then my insurance paperwork was lost. Then I thought I had to change doctors because of scheduling conflicts. I started the switch and then the conflict went away and I went back to the first doc. It is a long frustrating road. Especially when you are anxious about it and just want to get on with the next phase of your life. I am now two weeks preop and start liquid diet on Monday. It is a long slow process but when it starts happening, it feels kind of too fast so hang in there.

Being pushy gets the job done! I was assertive with my insurance company and my surgeon and his staff seemed pretty confident that I was going to get approved and he told me surgery would most likely be after the holidays. (I had my first appt Dec 1, 2014).

He was right. I had surgery Jan 16, 2015. From being pushy and asking constantly what I needed to get done, what paperwork, scheduling my psych eval, hell, my surgeons office even gives everyone a check list.

Hi All!

So i am still in my pre-op, insurance requirements phase, which is long and annoying in itself..lol. I have Cigna, and they require a 3 month pre op supervised diet with a nutritionist, I have only one more visit before they can submit to my insurance.

So i have been working really hard at getting all of my pre-op appointments/tests completed before my last NUT visit, which is April 10th. I have been in contact with my surgeons office, and LUCKY ME, they have a brand new coordinator there. I spoke to her for the first time a couple of weeks ago, and let her know that i am definitely ready for surgery (i made my decision back in November) and I want to have everything done before April 10th so that they can submit to my insurance and I can get my date.. at that time she stated that I could possibly have a date of April 13th, I thought that was very strange, because i need my insurance approved first, but it got my hopes up a little.

I have completed all of my bloodwork and tests, and called yesterday just to ask some general questions about when i can have a pre-op appointment, and if it can be before the last nut visit, and also if they will submit to my insurance immediately. I really need to know for work purposes, and also I have a lot of social obligations in April, and May (christenings, parties, communions, baby showers, and weddings) i just want to be sure that if i can't attend i will give enough notice. I think that she may have been having a bad day, because she stated i was still missing things that she had confirmed were done on our last call. Then she said well nothing is going to be done with this until you are closer to being done with your NUT visits, so I can't tell you anything. I only have 1 left and it is on April 10th, so she rushed me off the phone and said i need to complete my requirements, and call closer to my date of being completed. Hmmmm, Now i feel bad calling again today, after re - faxing everything i had already faxed over. I don't mean to be pushy, I am just ready, and want to do this as soon as I can... Sorry to vent guys!!

My surgeon's coordinator was unmotivated from the beginning. One the first day she told me my insurance didnt cover the surgery when they had given me his name So she calls them and "Yes if it's medically necessary". What insurance covers non medically necessary WLS? She also said she wouldn't fax "200 pages of documents to the insurance " so she hoped hadn't been to the doctor very much. She was impossible to reach. I began Emailing her instead of calling. So I am on my website for my insurance this morning checking my prescription prices and I notice a tab that says "authorizations". Curious I click it and lo and behold I find out that I have been approved for my surgery for March 30. On top of that it was not my surgeon's coordinator (who is still collecting documentation she said I needed) who got the approval it was my PCP'S office. Now he referred me back in January. So how long has this approval been sitting here? What really frustrates me is that I told this coordinator that I shouldn't need all this documentation and testing as my BMI had been greater than 40 for the last 2 years and I have Medicare, even though it is an Advantage Plan. My PCP's nurse had supplied me with all of my BMI's and had faxed them to this coordinator as well. Obviously she submitted this information to my insurance and while the surgeon's office was wasting my time I was already approved. Well Water under the bridge. The great news is I am getting sleeved March 30th yea‼️

@@smile121 It seems that the person you are dealing with has forgotten that you are the client and her job is to provide service. I would call her up again and confirm that she has received the information. I would also ask the questions you have and get a plan. It is the middle of March. She should have a good idea of what is happening in April!

If it was just a bad day then all should be fine. If she remains unhelpful, report this to the office manager. I had an experience where the scheduler came out into the waiting area and yelled at me about not having my stress test done! I informed her it was scheduled and walked out of the office. A few minutes later, I realized that bad behavior is just not acceptable and I was not helping by doing nothing. I walked right back in and spoke with the program director. I am so glad I did. I got an apology from the scheduler, but more importantly, sent a message that there are standards of behavior that are not optional!

Thank you for all of your replies. I feel bad bashing her, because i am sure this is a very overwhelming job, but I think we just want these coordinators to realize that even though they deal with the same issues everyday, this is the first time we are going through it. We don't know how it works, and frankly, this is probably the most important decision i have ever made for myself. I just want to understand the process and be sure that i am doing everything I can on time, and that she is doing everything she can to help me. I am going to call back again today, and risk looking like a "stalker" hahaha.

@@lynneanne - I can't believe you had to go through that! WOW! yes def Water under the bridge but that is super annoying!

Thank you for all of your replies. I feel bad bashing her, because i am sure this is a very overwhelming job, but I think we just want these coordinators to realize that even though they deal with the same issues everyday, this is the first time we are going through it. We don't know how it works, and frankly, this is probably the most important decision i have ever made for myself. I just want to understand the process and be sure that i am doing everything I can on time, and that she is doing everything she can to help me. I am going to call back again today, and risk looking like a "stalker" hahaha.

@@lynneanne - I can't believe you had to go through that! WOW! yes def Water under the bridge but that is super annoying!

Thanks!

Id give her another chance, maybe call back tomorrow. I'm also a nurse and although I don't think it is okay to be short and unhelpful with patients, things can get a bit hectic. Good for you keeping everything in line, thats definitely the way to go about it.

My surgeon's coordinator was unmotivated from the beginning. One the first day she told me my insurance didnt cover the surgery when they had given me his name So she calls them and "Yes if it's medically necessary". What insurance covers non medically necessary WLS? She also said she wouldn't fax "200 pages of documents to the insurance " so she hoped hadn't been to the doctor very much. She was impossible to reach. I began Emailing her instead of calling. So I am on my website for my insurance this morning checking my prescription prices and I notice a tab that says "authorizations". Curious I click it and lo and behold I find out that I have been approved for my surgery for March 30. On top of that it was not my surgeon's coordinator (who is still collecting documentation she said I needed) who got the approval it was my PCP'S office. Now he referred me back in January. So how long has this approval been sitting here? What really frustrates me is that I told this coordinator that I shouldn't need all this documentation and testing as my BMI had been greater than 40 for the last 2 years and I have Medicare, even though it is an Advantage Plan. My PCP's nurse had supplied me with all of my BMI's and had faxed them to this coordinator as well. Obviously she submitted this information to my insurance and while the surgeon's office was wasting my time I was already approved. Well water under the bridge. The great news is I am getting sleeved March 30th yea‼️

I’d call and confirm that authorization is actually for the surgery, if it came from you're PCP's office it might be just the authorization for you to have office visits with the surgeon and not for the actual surgery. I'm pretty sure the authorization for the surgery will come from your surgeon’s office.

I am having issues with the assistant insurance coordinator. I went in for my initial consultation 1/22 after that appointment it felt like I was bombarded with emails from the nutritionist, insurance, test results ect. It was great. I turned in all documentation,took my psychological evaluation and everything by 2/5 and today is 3/13 and they still haven't sent in for insurance approval. What is the deal? I have done everything. Why are they not submitting the info. Is there a process that I am unaware of? I called and have been calling for weekly status updates. I have been told I have everything turned in and when they submit it to insurance they will email me. Last week I called and was told this is elective surgery (like I am not aware) and they have like 50 files ahead of mine. This week I called and left a message and no one returned my call. So I called back and the receptionist was told by the assistant insurance coordinator that the insurance coordinator had my file and was working on it. The receptionist relayed the message to me. I can't believe they would not take my call. It's not like I have been calling them daily I have called every week for the past 3 weeks. I am hoping to have surgery while my daughter is out of school for spring break. The 2nd week of April. I live out of town and that is when would work best for my family. Now if I can get the clinic, Dr's and insurance coordinator on board. Am I expecting too much? How long has this process been for others?