littlemiss0428

Hey all!!!!! OCTOBER 23rd is the date!! Im 39 with a husband, 3 girls, and a busy job as a nurse. So excited about our journey, and cant wait to officially sit on that "Losers Bench".. Dr. Jawad is my surgeon, and I live in Orlando FL....

After all of my insurance drama, I finally have a date for October 23rd. Apparently Dr J. is going on Vacation, so I im on schedule when he returns. Im not even upset about it. It gives me some time to rearrange my schedule for work, and ask for that time off so I wont be rushed! Excited... I know this time will fly by!!

@ skinnyMinnie2Be-- wow! 4 whole weeks of liquids.. I was surprised, but my Dr wants a modified diet (low carb) Now until 2 weeks before the surgery. Then 2 shakes a day/Light meal for 2 weeks, and Clear liquds 24 hours before.

Hi Mendif- As you know, Cigna is very tricky.... I would call them around 2 weeks after everything is submitted. My appeal was submitted on 7/20/12 and approved on 8/1/12. They will tell you it wil be 4-6 weeks, but it doesnt hurt to call or follow up on the process. Also make sure you have your bariatirc qualifications (psych eval , medical neccesity AND Clearance for surgery, etc). It helped me to have a check list to make sure ALL paperwork was submitted. You can write additional reasons, but if you meet qualifications, and all the required paperwork is in place according to Cignas poilcy, you're in!! Praying for a speedy appeals process

*Going

Thanks so much! I know I have so many new things ahead (Liquid diet, post-op,) so jumping this hurdle was wonderful! KZBen-- Are you local (Central FL?) I first thought about doing to Dr Kim to be my surgeon, but decided on Dr Jawad.

Hi Odee: Im a little late jumping in, but Im in the EXACT situation as you. Im currently in the appeals process.. My surgeons office send over All the paperwork except the medical clearance. That was denied. He then re faxed it again and that was considered the second attempt. I went to primary and got the medical clearance. Its too late now and cigna wants a peer/peer. The office doesnt do peer to peer even though it was the doctors fault, and after I explained that it doesnt need to be with the Dr. So now we are at the appeal process. I can find another Dr, re submit and then that should approve it, but what a hassle! My surgeon is considered one of the best in this area, but the office staff isnt helpful. (sounds like a lot of other surgeons)

@AliciaA122~ didnt want to scare you (lol). I was anticipating an easy approval. Ive read lots of members on VSGT getting approved in 2 days with Cigna, but this wasnt the case with me. I dont think my surgeons office was aware of the medical neccessity/clearance requirement, and I didnt fully understand it either... Just one of those things.. Im sending wonderful prayers that your approval will be in a short length of time

I have Cigna OA as well... Its been a nightmare!!! At this point Cigna has ALL the paperwork needed for approval, but due to the surgeons office faxing everything over for a second "reconsideration" before the my medical necessity/medical clearance was included, cigna now wants a peer to peer review. I should write a soap opera about all this drama.. MY ADVICE TO ANY ONE WITH CIGNA.. have a journal with dates, names, and topic of all calls.. The customer service is very nice, and most of them have tried to help, but they arent the decision makers. This whole experience is very annoying, and confusing...

Little Bits: you did it!!! Im so proud of you I cant wait until you tell us details!! Remember to walk ,sip, and rest....

Im still waiting on final approval..I submitted to insurance end of May. My primary doc has to re-write her recommendation letter Re- submit, then I pray that this goes through.....

Thats true.... One of the most re-assuring things when I finally decided if this was right for me was watching You-tube videos. its really motivating to see someone just like you change before your eyes with pictures, and learning the ends and outs from their words....It feels as though we are taking the journey with them

You know... I thought of the same thing. I work in a nursing home where Im in contact of peers, patients, and their family members on a DAILY basis. If I wear a different shirt, someone has something to say about it (LOL), So I know when the weight falls off, and Im not around grazing at the pot lucks, or birthday parties, people may (or may not) have comments or questions....

I just checked it out!! You were great... Short and sweet (If those vids are too long, I usually skip around anyway). Ive been debating on if I should start a vlog as well. For me, I know it would officially make my choice of WLS open to the public. But, So what?? you only live once Great Job!!!

I didnt expect this "insurance game" to play out like this. Bear with me --this may be a little lengthy... My first letter from Cigna (OA) was last week.. I posted my frustration, but felt as though things would get approved. This past monday I received an official denial. The letter stated that they needed the letter from another physician other than the surgeon. The problem is that my primary physician wrote a letter that included my weight, BMI, co-morbitities, and that I would be a good candidate for the surgery. this was included in my file. I spoke to my Pre-determination cordinator, and he didnt know why it was denied..... I called Cigna and asked them what were they looking for, and what is the next step.... Mind you, EVERYTHING ELSE is there. I thought perhaps my surgeons office did not fax the primary's MD's letter. They faxed a "reconsideration" letter yesterday, and it was denied today. Feeling very anxious, I called Cigna, and explained everything, and wanted to know if my letter from the primary was there. The rep from Cigna was very nice. She found the letter, but it wasnt worded specifically for Cigna. They want the wording to specifically say that I am healthy enough for surgery, and that I am medically clear from the primary's standpoint. Ok.. so i called my primary's office, and now they are saying that the Dr may not clear me medically because I dont have a surgery date yet. I called the surgeons office AGAIN, and he said that he will schedule me a "dummy" date, and will fax the correct "verbiage" to the Primary... So now... we wait Well... by the end of all of that, I could even concentrate at work. I had so many feelings going on. I felt like the go-between with my surgeons office and Cigna.. I felt like my pre determination guy isnt working hard enough.. (He seems too nonchalant for me). Are these normal feelings for someone in this situation? Is there anything else I could do? At first I thought of other routes (i.e Mexico) or giving up all together..I was really having a pity party BUT after I looked at other people who have done this, and who are living better, healthier lives, Im ready to fight again! I will not give up on the count of some technicality... Ive met all the qualifications for this, and Ive put so much of my time, and money into this. Ive worked really hard trying to get this together, So the Saga continues.... I will keep everyone posted.... p.s. I know I have some typos, but I cant find the spell check.. lol

Thank you so much!! I mean... I get it.... Cigna is going to make sure every "T" is crossed, and every "I" dotted.... I just pray that everything works out, and that I get this done soooooon (lol)

Yep... Thats pretty much what they wanted. My Surgeons office gave me a "template letter" to give to the primary doc, and the wording still wasnt what Cigna wanted. (Go figure). Thanks for the encouragement!! I will follow up with everything on Monday

**Having

Another reason why I had a change of heart is that with the LB, you dont have restriction at first, and that it takes quite a few adjustments to get to your "sweet spot" I didnt have the money time or patience for that! Also If I am have MAJOR surgery with anesthesia, I want it to be the most effective, with the fastest results!!!

We are in the same boat! I was pro lap band and went through all my pre op testing thinking: lap band.. I didnt want my stomach cut! After lots of research, i think we both made the right decision!! Im excited about the upcomming surgery, and changes in my life..as a SLEEVER!!

We are in the same boat! I was pro lap band and went through all my pre op testing thinking: lap band.. I didnt want my stomach cut! After lots of research, i think we both made the right decision!! Im excited about the upcomming surgery, and changes in my life..as a SLEEVER!!

Ok... Trying not to scream...Breathe... Ive submitted ALL my paperwork to the insurance company on 5/30/12. I was surprised when I received a letter TODAY from Cigna. My smile quickly turned into a WTH(heck) when I read that they unable to authorize my request for the procedure until they receive "additional" clinical paperwork... What additional clinical paperwork?? I've had 6 months of diet/ excercise signed off by ARNP, psych eval, upper GI, gallbladder ultrasound, MD visit, and Nutritional eval. I was soooo hoping to get this done sometime in June, because I begin nursing core classes in July. At the bottom of the "Delay" letter it states: "Please be aware this is not a denial. Once clinical information is received from the provider we will make a medical necessity on decision on your case" .....what??? My Surgery Coordinator will definitely hear from me first thing in the morning, but until then Im pissed!! Any encouragement is greatly appreciated...

Thanks ladies... I really appreciate the feedback. Ive decided to have WLS in August 2011. I originally decided on the Lapband, but decided about 6 weeks ago on the Sleeve.I beleive this is the best decision for me. I will keep you guys updated on my status...

I hope the same quick response will work for me as well... I have Cigna open acess, and The Pre determination department faxed the paper work over last friday (I beleive). They faxed my psych eval this past Tuesday, so Im hoping thats the hold up.... Im getting a litle anxious.... and excited at the same time

My Closest family is aware of my decision and is supportive. My Brother questions if this decision is too "drastic". One of my closest friends think all I need is a good trainer..... BUT she is only 125lbs!! lol. We tend to worry about what others think of, or if they approve of this decision. a the end of the day its YOUR decision. You feel negativity from others, but dont mention it to them again.... and Keep going!!