nicolemm

Has anyone had a peer to peer with Cigna? If so what was the outcome? My surgeon has an 830 call with them tomorrow morning, all because they read my clinical notes wrong. They hve verbally acknowledged their mistake but now since it was denied need a peer to peer

Approved after my peer to peer today! My surgery will be on 12/12/12! Anyone else? I started my preop yesterday. I don't have to do liquids but a 1,000 calorie diet. So far, so good.

Did any of you banders get denied on the first try and then their surgeon did a peer to peer review? Cigna inaccurately read paperwork on my first try and denied my claim. My surgeon has a peer to peer call with them tomorrow morning and I'm hoping for the best as my surgery is scheduled for December 12. I'd love to know if anyone else went through this and the outcome because I am panicking.

After all of my anxiety my surgeon told it it took all of 3 minutes for them to reverse the decision! Thank goodness, getting banded on 12/12/12! I am so excited for this new chapter

I have Cigna and my surgeon has a peer to peer review tomorrow. Cigna claimed I didn't complete my three month nutrition counseling, although I did, they did not read my clinical notes correctly. I am SO nervous to be denied after the peer to peer review. My surgeon is confident it will be approved but the anxiety is driving me insane.

So today I received a call from my surgeons office that I was denied by Cigna because the letterhead from my nutritionist did not match up with the letter head from my surgeons office making them believe I didn't complete my three-month nutrition program. The surgeons office called Cigna and they saw their error but now that they've denied it my surgeon has to call for a peer-to-peer. He seems confident they will reverse the decision and is keeping my surgery scheduled for dec 12 but I am nervous now! Does anyone have experience with this? What was your outcome?

Tell me about it! My heart sunk to the floor when I got the call. I'm going to have anxiety until I hear back now.

Your insurance may require monthly appointments with your surgeon. Mine experience was similar in that I met with him in August and then went back in September a few weeks later to check-in even though I had all the other appointments to complete (endo, psych, sleep study, nutrition). Surgery is December 12!

Does anyone know the rules on coffee and preop diet? I start mine on Wednesday for Dec 12 surgery. It's food-based, not liquids. So 1,000 calories a day...8oz lean protein, 2 fruits, 2 veggies, etc. I'm seeing my surgeon Tuesday for my preop appt but want to start the diet Monday since its the beginning of the week. And if coffee is a no no it's going to be hard!

27 here, getting banded on December 12th and I cannot wait to be healthy! I've been overweight for what seems like my whole life. I can't wait to see what the future holds!

I start in one week, the 28th. My dr gave me a 1,000 calorie food based plan rather than then liquids though so I'm thankful for that!

I'm sure they can get you in earlier. When I went for my endoscopy and appt with an endo dr in August they were booking into October/November and told me they were "very busy". I told my dr about this and he called for me and I got in two weeks later. I had to be very flexible about date/time but they made it happen! Good luck

I have a surgery date and went through all of that testing and am still waiting on final approval. I was given the verbal ok to schedule from the precert department at Cigna about a week ago but when I call for progress they tell me it's pending! Good luck!

December 12 here! Can't wait!

I know how you both feel! I started the process in July doing exactly the requirements you listed. I finished all of the appointments by Oct 15 and am finally having surgery on December 12! The wait really is the worst part, good luck!

December 12 here! Was supposed to be November but Cigna took a lifetime to approve! Start my pre-op the 28th!

I have Cigna. I decided to give them until Wednesday of this week before I really start nagging because my final appointment was the 15th. My surgeons office will not give a date until all appointments are done and insurance has approved. I'm so antsy now though!

How long did it take you ladies to get dates? My paperwork got submitted to insurance last week and now I'm just anxiously awaiting the call. I'm so ready!

I had my final appointment this afternoon! Office will submit paperwork to insurance and the next call I get from them should be a surgery date. I can't wait, I'm going to hate this waiting game!

She won't clear you bc of the murmur right? Not the apnea? I was under the impression that apnea is anther reason FOR having the surgery! I am counting down the days/hours until my appointment on the 15th to get the final approval! I am getting frustrated though because the psychologist hasn't sent my report along although he gave me the verbal go ahead.

My pre-op diet is pretty much the same. 1,000 calories. I'm allowed 8oz of lean protein and some fruits and veggies. Luckily my nutritionist is all about eating real foods so the shakes aren't as vital in the pre-op diet she gives. T

No date yet but I got cleared by my nutritionist and psychologist to be banded. Meeting with my surgeon on October 15 for final approval for November! I cannot wait! I keep telling myself that it's one thanksgiving of soft foods and its going to be soo worth it!

So as I've been going through all my appointments it's been concluded that I have no co-morbidities to go along with my high BMI. Normal blood pressure, good cholesterol, I am able to excersize and no sleep apnea. All in all this is good health wise. BUT I am so nervous my insurance wont approve bc of this. my BMI is 45 which is very high. did anyone have trouble getting approved with no co-morbidities? My dr says I should be approved because of the bmi alone but as we've all probably found out along the way, nothing is guaranteed.

With Cigna it's taken me about 3 months with my final appointment on October 15. Cigna likes to see a three month waiting period according to my doctor and the woman at his office that deals with insurance. So far I've had my initial appointment, an upper GI test, an appointment with the nutritionist (today is my second appointment with her), an appointment with a pulmonologist to discuss apnea, an appointment with my surgeons APRN, a sleep study and a psych appointment. It's taken me about 2.5 months to do all those appointments and they are going to submit my paperwork to insurance after my appointment I the 15th. It's been a lot but I know it'll be worth it! Good luck!

That's good to hear! What type of insurance? I have Cigna. Dr will submit my paperwork after my last appointment on the 15th.