xrayyoung22

My surgery is July 20th and I'm on day 2 of the pre-op all liquid diet and it sucks!

I am finally finishing up my 90 day pre-op diet. I've successfully completed every other requirement by my insurance (psych evaluation, bariatric classes, nutritionist appt, etc) and my last pcp weigh in is in a week. I spoke to my patient advocate today to make sure my ducks were in a row for approval and she now says, for the first time today, that she needs medical records from 2013 and 2014 showing my BMI was over 35 since then. My BMI was under 35 in 2013 and nowhere in Cignas requirements (I've read the policy many times and called Cigna many times) does it say anything about needing two years of past records for approval. When I told the patient advocate this she told me they always ask for it. Does anyone have any info on this because I'm at the pre-op finish line and now this is thrown at me, and I'm devastated.

Soooo, I got the call today!!! My surgery is scheduled for June 20th!!! I cannot even express my excitement right now!!!

I would be so upset too. I'm sorry. That is tough but I'm glad you called.

@megieg: I call Cigna everyday. I apologize to them but remind them that to them, it's just a job, but to me, it's my life. Cigna reps are usually very understanding so maybe you should call. PS: I still don't have an answer so not sure calling helps.

I just wanted to touch base with everyone on this. So, my paperwork was submitted last Wednesday. I was denied on Friday (less than 2 days later) but not because of past medical records but because Cigna didn't like the documentation of my 90 day supervised diet. My doctor submitted MORE paperwork specifically discussing diet, exercise, calorie intake, etc on every single doctor apt I attended in the past four months. It has been two days now and Cigna still has my file under the "reconsideration" category but with no answer. I don't know if this is a good thing or not but I'm praying that nothing else comes up and I will have an approval by next week.

Thanks everyone. I submit to insurance next week. I will keep you posted.

I have a total of three required things left: nutritionist appointment next week, pre-op surgery class on June 2, and then final appointment with doctor. June 15th is the day I can submit to insurance and I will be nervous until I'm actually approved.

I am in the same boat in regards to approval. My BMI is exactly 40 and I have no co-morbidities. So, although I am supposed to be on a 90 day dr supervised diet, if I lose weight I will be disqualified to have the surgery. But if I gain weight during the 90 days, insurance may not approve. I agree. It is quite nerve wracking waiting; especially when you have already committed completely to the surgery and are counting on it. Hopefully in the next few weeks, there will be some posts with people who have been approved and have scheduled their July surgery.

I can only imagine how tough that must be, but you got this! I cannot make my surgery appointment until after my insurance approves it and I have to wait until June 15th to submit so we will probably be having surgery around the same time.

The cost. WLIA had a lot of extra costs that Bridges does not so the out of pocket cost for me at WLIA would have been about $3000-$4000 more than at Bridges.

I have my psych eval tomorrow and it is causing me a little stress. Can anyone tell me if this is a big deal?

That's exactly how I feel too @cmhueto. I'm about six weeks from submitting to my insurance but I'm also anxious about this when reading people's experience.

Hi all, I am about halfway done with my required 90 dr supervised diet (and haven't done well at all) but I should have at least maintained by the time I start my two week pre-op diet so that shouldn't interfere with my insurance approval. The surgeon and I have decided that the sleeve will probably be my best choice but could go either way (sleeve or bypass) since I don't really have any co-morbidities and the sleeve has less risk factors. I was very comfortable with that decision until I see a lot of posts about people eating the way they ate prior to the sleeve within a few months out. Please tell me this is not the norm. I have 100 pounds to lose and the idea of losing 50 pounds and then being right back to the place I was before (eating terribly, gaining weight, etc) scares me. And I know that it is mind over matter, but it is that way with diet and exercise and none of us would have surgery if we could master mind over matter. I'm just wondering why you all chose the sleeve rather than bypass and for reassurance that this surgery isn't a short time fix and will forever change the way I eat. And if any of you wish, after the fact, that you had had the bypass and not the sleeve.

I understand what you're saying. I think my question is, how do you use this as a tool forever. I've been at goal weight several times over the past decade using other tools (weight watchers, diet drugs, etc) but I've always gained back. Anyone who has had WLS has battled weight and tried many things to lose weight only to lose and gain. How is the sleeve as a tool different is what I think I'm now wondering?

I met with the surgeon today. He said if all goes well, I could be looking at May or June for my surgery but surely it cannot be that easy. I have a 90 day waiting period for my insurance. Does anyone know if you just need to go to the doctor for three consecutive months, even for non-weight issues? Because, at every appointment the doctor certainly takes my weight, talks about my high blood pressure, and asks what I'm doing to change it. So, I am hoping that this is the case. If so, I will be a May or June sleever too!

Hi, I am in the middle of my 90 day insurance waiting period/doctor supervised diet period. I have a couple of questions. First, am I supposed to be trying to lose weight? Because if I do, I am worried I may fall out of the BMI range that allows me to get the surgery. And secondly, I know everyone loses differently but I am just wondering if I could get a guestimate about how much weight I can expect to lose in 2 weeks post-op, 3 months post-op, six months post op, and a year post-op. Thank you.

I'm new to this site but so glad I found the AZ thread. I meet with Dr Juarez this week. I'm changing from WLIA. Any advice? Im hoping I don't have to start my 90 day insurance required period over.