AliciaA122

Oh yeah, I'm definitely trying to stay involved. It's hard for me to relinquesh control and depend on others to do what they're supposed to do. I call the insurance company and surgeon's office at least every other day. They probably know the sound of my voice by now. It's just frustrating to be told that everything is in hand and going to insurance only to find out that wasn't true! Just called their office and found out that as of Friday Dr. Elliott is no longer with Henrico Surgical Specialists. Now I really don't know what I'm going to do. I have to find a new doctor/practice. Right in the middle of the approval process.

Well RDO, I'm getting a taste of what you went through with Dr. Elliott's staff. Got a letter from insurance Friday that my surgeon's office hadn't sent information regarding medical necessity along with my package for approval. So, things are delayed. I'm very frustrated. They have an insurance specialist. Shouldn't they kind of have an idea of what they're doing? I'm going to try calling them again this morning and see if I can talk to her.

I called Cigna today. I was told they received my information yesterday from my surgeon's office and my case is now in nurse review. A decision should be made in 24-72 business hours. So, that's my timeline. I'll be calling everyday until I know something.

well, called the insurance company today and they have received my information from the surgeon. She said it is in nurse review and they should have a decision in 24-72 business hours. Yikes! So, I'll be calling everyday of course. Just glad to know the surgeon's office sent the packet in at least!

I have Cigna too. My requirements were all done last week but my surgeon's office has yet to submit my package to them. I'm still waiting. Hopefully you'll get an approval soon!

So, all my requirements are done and everyone has submitted their stuff to the surgeon's office. But, doesn't look like the surgeon's office has submitted anything to insurance yet. As of Wednesday last week they had everything and told me they'd call if they didn't. I hate being a pest, but I want some answers. No one over there seems like they want to actually talk to me about the process. Just keep saying, we'll call you when you're approved or denied. Ok, thanks, but why can't we talk this through so I have a better understanding of time and process? Frustrated with the communication for sure! I'll just keep calling and checking every few days. Also not sure why the receptionist will never actually put me through to their insurance specialist.

I talked to my surgeon's office today and was told they received the notes/referral from my PCP this morning. After doing a cursory glance she said it looked like they had everything they needed. My surgeon just needs to review my PCP's reports and then everything will be submitted to Cigna. Ugh. I'm so nervous. I hate waiting.

Still, you're approved! So that's a major relief at least!

wish I'd seen that in May! I heard about it being changed but couldn't find the official policy at the time. Would have saved me two months of visits!

Oh yikes! I have Cigna. This is scaring me. Had my last of my 6 month doctor's visit's today and have done the nutritionist and psych evals. Hopefully my surgeon's office will be able to submit everything this week or next. I'll stay on them and Cigna!

I have Cigna too and I've also heard the 3 month thing. I know there is a 3 month multi-disciplanry diet you can do (or used to be able to do) that's more intense than a 6 month PCP diet. I had my last PCP appointment today in my 6 month diet. I have done all the other requirements, so now it's on to Cigna for approval... well, after my PCP writes his report and notes. Fingers crossed for you Emily! Update us on how it turns out.

I'll tell you that there is a wide range of what the psych evals entail. Mine was not about behavior modification, well, there was a little of that, maybe 5 minutes. Mine was more about my life history, trauma, weight issues, a little bit of everything. I have heard where others have to take tests. Others get asked strange questions. So, it could be anything!

Wow! That stinks. If you don't mind me asking, why do you assume you'll be denied?

I'm way late to this, but thought I'd throw in my opinion and experience. My husband and I tried to conceive for a couple of years on our own with no success. We went to a fertility specialist and began testing. At the same time I began looking into Lap Band. My fertility specialist AND primary doctor both told me to try to get pregnant first and then pursue WLS. I was 31 when I began fertility treatments. However, my fertility specialist told me that by having the surgery I would be taking another large chunk out of my fertile years. He could find no reason that my weight was affecting my fertility and as it was we were undiagnosed. We began treatments including Clomid, injectable meds and IUIs. We conceived our daughter on an 'off cycle' after an IUI cycle. She's 14 months old and I'm now very close to having my sleeve surgery. SO GLAD I listened to my doctors. Also, to the previous poster who commented that you can just adopt and that there are so many babies who need homes. If only it were that easy. Adoption is painfully slow, definitely not a guarantee and very expensive. You can't 'just adopt.'

I had my final appointment in my 6 month doctor supervised diet today. My weight was up from last time. Yuck. He said that shouldn't matter though. The entire 6 months it's been up and down. Now he submits his notes and report to Dr. Elliott's group and then they package everything up for the insurance company. Getting more excited and nervous now as it all seems much more real.

RDO- I have a question, if you see this. The manometry and 24 hr pH test, are those requirements for your insurance or Dr. Elliott? I haven't heard anything about them.

Hi all! I'm in Powhatan too and see Dr. Elliott. Haven't had surgery yet but am hoping I will next month or September. I have seen the nutritionist and had my psych eval. I have my last doctor's visit in my 6 month doctor supervised weight loss plan on Tuesday! After that all of my information can be sent to my insurance company for approval. Fingers crossed! I haven't been told about any other testing or other requirements, so I'm guessing that will happen after approval.

If you don't mind me asking, why were you denied 6 times? Was it a lack of documented weight history?

Good luck! I have Aetna too and am just starting the process. I just met with the surgeon yesterday and have to decide if I want to do the 6 month doctor supervised diet or the 3 month multi-disciplinary program. If I do the 6 I figure I’d be banded late October/ or November. I can’t decide which to do… so I’m calling the place that runs the 3 month program today for further details. I'm leaning toward the 3month because it would mean being banded sooner and that's a good thing. But we'll see.

Wow Larry! That's phenomenal. 102 pounds in 5 months?! Good for you!

I haven’t had the surgery, but your weight loss sounds very good to me… and normal or above normal, I’d assume. The goal they gave us at my seminar is to lose 1-2 pounds a week and you’ve lost 4.5 pounds a week!

Thank you so much! Your post is chock full of very good information. I really appreciate you taking the time to share it with me. I am hopeful that if my weight is what’s preventing us from conceiving then this surgery will help us.

Hi! A little about me. I am Alicia, 30 years old, from central Virginia, married to a great guy who is very supportive and loving. I am just at the very beginning of this process. I have attended a seminar, done a lot of reading and lurking here, and have an appointment with the surgeon a week from tomorrow. My insurance has the WLS rider. I am currently around 310. :biggrin: I need to lose a lot of weight, 150+ to be at a normal weight. But, my own personal goal is to be at the 200 mark. I have a number of motivating factors, but the biggest one is to start a family. My husband and I have been trying to conceive (off and on with breaks) for about 2 years. I have an appointment with a fertility specialist in June to find out exactly what is going on with me, though I’m pretty convinced I have PCOS due to all my symptoms. My PCP says I should try to have a baby before WLS, but I want to pursue both concurrently and see where it leads. I know I will have to do a 3-6 month supervised program for insurance purposes, so that will allow me to meet with the fertility specialist and get his opinion. I’ve probably shared too much. But, that’s me. I look forward to this journey and am excited at the prospect of shedding the pounds.

Congrats to you, K! 20 pounds is still...20 pounds gone and closer to your goal. That must feel good!

I too enjoy a beer every now and then and have 2 diet pepsis a day! I know I’ll have to give them up if/when I am banded. But, I’m willing to do it for the sake of my health. J My hubby suggested I could just let them get flat before drinking…hah!