Mvpo8961

lasonyadj, how has your process with CIGNA going? I would be in the fourth month of a six month program at the end of January. However I saw my surgeon yesterday and am going to self pay and go ahead and have surgery. He has told me that they haven't had CIGNA approve ANYBODY yet. Just curious how yours is going. M

JillRn I have been an RN for 23 years. Although presently I am a SAHM while homeschooling my 15 y/o. No it is not ethically wrong to flip to FT then when you need to go to back to PT. They are paying YOU for your talents and work not the other way around. Insurance is part of the TOTAL compensation package. My husband is an ICU manager and this is how they look at ins as part of the total compensation. You are a valuable asset to THEM. Go for it and be HAPPY. M

Well I had my "last supper" during the Rose Bowl last night. Now I start my preop diet. I chose a Sonic Chili cheese Coney with Chile Cheese Tator Tots, Mozarella Sticks and chocolate shake. Share what you had please. M:p

JillRN look at Cigna's Healthcare Coverage Position Statement for Bariatric Surgery. There are a number of references that you could pull for your appeals. Go to www.cigna.com and do a search for 0051 this will pull up an alphabetical list. From there go down to bariatric surgery. They have a 20 page position statement on BS with 88 references. You should be able to pull some of there references to support your case. M:Bunny PS anybody with BCBS insurance should look at the references that Cigna uses from BCBS Technical Evaluation Center. It might help with appeals also. M

Go to www.sinusbuster.com and look at that product. My husband has chronic winter sinus congestion. Last year it worked into bronchitis, pneumonia and then an inflammation of the chest wall lining. I bought some of the sinus buster this year and he says it is really helping. If he goes a day or two without using it he starts to get congested. M:)

Non Sterodial Anti Inflammatory Drugs such as Aspirin, Ibuprofen, Naproxen (Aleve) are the most common, over the counter ones. M

:nervous Congrats on your surgery. Hope everything continues to go well. M

I having been reading for a while but am a new poster here. I have a dilemma and would like for ya'll to tell me what you think if it were you.I am 3 months into a 6 month supervised weight loss program. I have Cigna HMO ins. I have had my nutrition consult and almost finished with my psych eval per my ins requirements. The other night I applied for Capital One Healthcare funding for my surgery and was approved. The catch is the funding is good for 90 days only (I didn't know that when I applied). Now wouldn't you know that happened 92 days before my six month program is complete and can be submitted to my ins co. I called Capital One to see if the 90 days could be extended and was told that was a firm date. However, I could reapply after that. They suggested that I wait my 90 days and fund the surgery at the very end (this is done by signing the paperwork and sending it back to them). Then you start repaying 4 - 6 weeks after signing. This would give me time to submit to my ins co and see if I can be approved for ins coverage. Then I could just repay what was borrowed in a lump sum back to Capital One. Called the surgery center (which by the way is NOT where the office of my doc is) and found out they are OUT of Network for my ins. So I would have to go to the hospital that is in network for CIGNA.I can sign the papers and then wait 4 - 8 weeks to have my surgery and see if ins will cover and then reschedule to the hospital and hope the surgery center will refund Capital One. I either have to have the surgery in mid Jan or wait till mid April due to husband's work situation. If I self pay it will be 400.00 a month for five years. 1. I can have the surgery and get it over with and just grin and bear the payments. 2. I can sign the papers and schedule delayed surgery at the surgery center, submit to ins., if approved reschedule surgery to in network hospital and hope surgery center will refund to Capital One. 3. I can wait for my ins. (with no guarantee of approval) and let my Capital One lapse, then reapply (without guaranteed approval) So what would ya'll do? Myra

:kiss I used to live in Texarkana, AR but moved to just north of Dallas. So I consider myself an ARKANSAN. But I will be rooting for UT tonight. M

GeorgiaPeach I am also tentatively scheduled for surgery Jan 19. I will be at the Surgery Center in Richardson. I have my preop appt Friday and then will need some lab work. I'll keep my fingers crossed for ya. M

Thanks everybody. I tell you it is really difficult when you know you can get surgery just by signing a piece of paper. I think what I am going to do is see my doc Jan.6 and pin him down on how many CIGNA approvals he has really had. I am not going to wait a year to change insurance to another that might not cover it. So when I see him Friday I will know if I am going to wait or not. My husband says to go ahead and have the surgery and not wait for ins. Nice to have family support which ever way it goes. By the way I am an insulin dependent diabetic of 15 years and have high lipids and a BMI of 46. So I have comorbidities that make it a worthwhile effort to have the surgery ASAP.

:nervous I'm not banded yet but I have a tenative surgery date of 1/19/06. I am going to self pay because my ins is one of the worst about covering band surgery. I have met with my surgeon once, the nutritionist and psychologist also. I have a preop appt on 1/6/06 and will get a list of blood work I will need for the surgery and then I hope everything will be good to go. M

Hi Nanahanna are you the same nanahanna that posts on the antique rose forum from Arkansas? If you are I am Mvpo. Just curious. M

Mainly because I have CIGNA insurance. The office manager at the surgeon's says they have yet to have CIGNA approve a surgery. She herself had CIGNA and submitted for surgery, was denied, appealed and denied again. I just feel if the office manager of a bariatric doc ( who knows the ropes because that is her job) can't get it approved realistically what are my chances? Everyone I know says CIGNA is the second toughest ins after AETNA. I don't want to waste time for a pointless endeavor. Does that make sense? M