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Soli3l

Gastric Sleeve Patients
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Everything posted by Soli3l

  1. Soli3l

    Cigna Conflicting Answers

    Thank you Butterfly, I am having the band removed 10/18 and then I have to set up another date for the Sleeve, I am uncertain how long I have to wait. I was advised that the hospital I am going to no longer allows the lap band to sleeve revision in 1 surgery. I will sure ask why on Monday for Preop Visit.
  2. Good morning: June 2012 the doctor suggested that due to a Slipped band and my diabetes and unsuccessful weight loss, I remove the band and get a Gastric Sleeve. June 2012 - CIGNA approved removal of the Lap Band, but denies the Gastric Sleeve. Reason: There is no documentation I followed Diet/Exercise Program. July 2012 - My doctor submitted paperwork again and got denied. September 2012 - Doctor gathered the 6 month Diet/Exercise documentation showing I followed the protocols, but due to my Diabetes and Slipped Band my weight loss have been unsucessful. The doctor said he would appeal the decision and resubmitted the paperwork to obtain authorization, they would contact me with the decision and surgery date. They submitted the Appeal and Insurance person confirmed CIGNA received it. I have been calling CIGNA to get a response to the Appeal and I get conflicting information: CIGNA says they have not received any appeal, the doctor has to resubmit. Appeal was denied Appeal was approved but there is a discrepency. Appeal was voided. Appeal was received, but is still under review no decision has been made. CIGNA says a decision would be made on 10/8/12 to call them that day Another says it takes 30 days for a response. CIGNA rep says it takes 45 days for a response. It seems everytime I call I get a different response. WHY???? What is the dept I need to talk to? I've spoken with Appeals Department, Precert Department, Provider Services. This seems frustrating. Thanks for reading. Soliel
  3. I am too 2 yrs post op Realize Band, and I watch my diet and my doctor has recommended the sleeve. He states it is my diabetes and insulin that has kept me from loosing weight, but states the sleeve will cure my diabetes. I look at it this way...its the 2nd attempt at Weight Loss Surgery and not as serious as the Gastric Bypass which will be the last resort. He also advised that back when I got the Band, it was advertised as working for everyone...but that was not the end result.
  4. Soli3l

    Cigna Conflicting Answers

    Ok, so after calling every day (multiple times a day), I spoke to the first Male Coordinator whom assisted me with correct info, he couldn’t transfer me to the Precert Dept, so he gave me the number (this is for Providers). They assumed I was the provider, stated the surgery was approved and requested I give the fax number so they could fax it over. At this time, I gave them the doctor's fax number and they sent it. When I called to get an additional copy, I was told that they don’t fax, they transferred me to the appeal's department, whom said surgery was approved but it takes 3 – 5 days to receive the fax. I then called my doctor’s office, they received the approval today, (because of all the leg work I did) and they will be calling me shortly to coordinate the Surgery. ***FINALLY APPROVED and IT HAS NOT HIT ME YET***
  5. Soli3l

    Cigna Conflicting Answers

    Thank you both for the input...yes I am still calling Cigna...now they say they haven't even received the appeal.
  6. Soli3l

    Who Are You?

    Good Day Everyonel, My name is Soliel and I am a Post Op - Lap Band Patient had procedure done on 7/30/2010 and only lost 15 lbs. I am a diabetic and my doctor says my slipped band and diabetes has hindered my progress, so he recommends the Gastric Sleeve. I have been reading this forum for months and decided to Join today. Thank you.

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