crecia1975

I am getting anxious and hope someone can help. I have Cigna Open Access Plus for my insurance. My paperwork was faxed to Cigna 08/17. I called today and it's still in "pending" status (whatever that means). I've seen others, on this forum, who have been approved quickly by Cigna. Do you have any tips to speed up the process? Should I call every day? (I've only called twice so far) I've already jumped through all of the hoops and now I'm really trying to get this approved ASAP. I have a high BMI so the surgeons office doesn't see why I would be denied, but I'm getting nervous because my paperwork seems to be at a standstill. I know Cigna has thousands of submissions a day, but I really want to get mine to the top of the pile. Any advice would be appreciated. Thanks.

I saw your steps and see that Cigna approved you very quickly. I have seen other people, on this forum, who seem to have had the same fast approval with Cigna. My paperwork was faxed to Cigna on 08/17 and they confirmed that they have it. I called today and it's still in "pending". Any tips on how to speed this up? Thank you.

Hi nduke39! Sorry to hear about the insurance exclusion. That sucks. I'm not banded yet, but I've met some great people here. They share so much info and it helps you feel like you are not alone. I understand feeling huge and having difficulty enjoying family time. I'm not much taller than you (5"3', but I tell myself I'm 5"4' when I stretch :laugh:). I hope you get some good info here just as I have. Good luck on your journey!

This sounds like my PCP. I went in for a physical right when I was starting the process to get LAP-BAND®®. I told her what I wanted to do and she proceeded to tell me she didn't think it was a good idea :sad:. Uh Hello!!....can't you look at my chart and see I have been fat for all of the years I've been coming to you?!? And that's after I've spent thousands of dollars on Jenny Craig and Weight Watchers! Then she started to tell me about two other patients who had the LAP-BAND®® and both have lost about 10 lbs in a year. Then she gave me some brochures for a Medifast clinic right across the street from her office.....and surprise! surprise! she works with them alot. Of course! She told me to check out that clinic and think about it before she would give me my letter of medical clearance/neccessity. I think she thought she could talk me out of it, but my mind was already made up before I went to see her. I waited about a month and then called her office to tell them I still wanted a letter. She made me jump through more hoops by making me write up all of my weight loss attempts including the dates, method tried, number of lbs lost and how long I kept it off. I guess she thought THAT would make me stop, but WHATEVER! I got all of that info and got my husband to take it to her office the next day since I wouldn't get there in time after work. Needless to say, I got my letter (actually a really good one by the way) and I'm just waiting on my insurance at this point. I can't wait to get banded and then see her at my annual physical. That just motivates me to use the band properly so I can tell her "nanny nanny boo boo!" :tt2: when I see her.

Congrats!! The 20th will be here before you know it.

Yes, I think so.

You swallow barium while an X-ray machine is on you. The X-ray shows the path of the barium as it goes through your digestive system. It shows if their are any abnormalities in your stomach or esophagus. I had to have one done after one of my supervised diet visits, at the surgeons office. Everybody scared me by saying how nasty it is, but it didn't bother me. I drank it right down and then drank the Water after it was done. The whole think took about 5 minutes.

That is awesome!!! That was really fast. I hope I get my approval that fast. My paperwork was just submitted on Tuesday. Who is your insurance company?

I feel your pain. I had to jump through the hoops of the insurance company as well. $50 copay for the once a month meeting for 6 months. $50 copay for a nutritionist visit. $25 copay for a psych eval. $200 deductable has to be met $1250 for surgery (out of pocket max for the year) It sounded like so much money to me until I added up what I have spent on Jenny Craig, Weight Watchers, diet pills, etc. I could have paid for my entire procedure by now!! I just told myself that is was better to just spend this money now and stop wasting thousands upon thousands with a new diet every year......and then still remain fat!!:thumbup: I'm not banded yet, but I still feel like this will all be worth it in the end.

Thanks!!

I found out my paperwork was submitted to my insurance company on Tuesday. I'm hoping and praying for a quick approval. I would really like to be banded in September. I'll cry if I have to wait until October.:thumbup: Wish me luck!

You know what? You did the right thing for you :eek:. You shouldn't go to a doctor that doesn't make you comfortable or feel good about what you are about to do. I would have gone to someone else if my experience would have been like yours, but mine was awesome :thumbup:. My consult was on a Saturday morning and I was the first appointment. I was a little late because I got a little lost and it was raining like cats and dogs. They still got me to the back in a reasonable amount of time. I had some questions, but he seemed to know what info I wanted so he answered everything before I could even ask. They have been great (so far) so I'm happy. I'm sure I would be looking at Mexico myself if I was self pay.

Why did you stop going to Dr. Kim, if you don't mind me asking? I first noticed his billboards, but was never really serious about getting anything done until I heard about him from my husband's co-worker. He got gastric bypass, with another surgeon, and has had issues. He is trying to go to Dr. Kim for a revision after hearing a lot of good things about him. I've done a lot of research and I only saw good things about him so I think I made a good choice. Does your co-worker like him?

That really sucks!!! I actually had a very interesting conversation with Cigna yesterday. I had my last supervised diet appointment on Thursday. I called Cigna yesterday afternoon just to check on my paperwork. They said my plan does not require preauthorization. They said WLS is a covered benefit and they don't need to see any paperwork until AFTER the procedure is done. As long as I've done my 6 months of diet, psych eval, gotten a letter of medical neccessity and have a high BMI I am set. They will just process it like any other claim. I couldn't believe it! I know I have to pay $1,250.00 for my max out of pocket for the year and I already have that ready. I actually asked the girl again to be sure and she said it's covered as long as it's outpatient. Now I don't know what to do. I think I'll just call/email the insurance lady in Dr. Kim's office and see what she says. I really want to get the ball rolling.

I'm trying to get mine through Cigna. I have the Open Access Plus plan and our coverage is pretty good so I'm hoping everything will turn out ok.

blondeej, I am going to Dr. David Kim. I really like him and his staff. They have really helped me with this insurance stuff. It's kind of made me afraid that something bad will happen since everything has gone so smoothly so far. :smile2: I would probably be going to Monterrey myself if I was self pay. Let us know how that goes. I would love to know just in case my insurance company decides to act a fool!

Hey blondeej! I also live in Funkytown (Fort Worth)! I just finished all of my appointments and paperwork on Thursday so I hope to hear something soon. I'm praying to have my surgery in September. I guess I kind of messed up the late 20's group thing since I'm 35. :frown:

Please DO NOT feel like a failure if you decide to get banded. I used to feel like that and then one day there was a "click" inside me and I didn't care what other people thought. It's about YOU and what you need to help you lose weight. Some of us just need a little help and that's what the band is--a helpful tool. I'm not banded as of yet, but I can't wait!! This is a way for us to live life the way it was meant to be lived. No one bats an eye if an alcoholic or a drug addict gets help so why is it so bad to get help with food??

I am friends with my boss, but I guess I'm lucky because we have the same sense of humor and she would not say something like that to me. She's thin, but she has been supportive and just asked questions. She just wants me to be careful since this is surgery, but she has never made me feel bad about my choice. If your boss continues to speak to you like that, you can report her for that mess. I would talk to her first and let her know she IS NOT funny and then see what her reaction is. Then I would report her if her reaction is as bitchy as her comments.

WTF!!!! That IS NOT a joke! Why would she say that?! Would she have said that if you were getting any other kind of surgery?? I would have said something smart and probably gotten into trouble.

I've been looking at all of the comments, in this thread, and I keep thinking "What the hell!!!!" Why is it ok to make fun of and be so rude to someone who is overweight? It's not acceptable to make fun of someone's race, gender or sexual orientation, but it's a free for all when it comes to weight. I get so sick of this!!!! A lot of this could be stopped if people started at home and taught their children to be less judgemental. Neither of my children is overweight, but they have been taught to never make fun or make a rude comment about someone else's weight.....or about anything else!! I've always taught them that making fun of others is mean and hateful.

I worked with a lady, who made a comment, saying I looked like the actress/comedian Mo'Nique. This comment was made BEFORE Mo'Nique lost a lot of weight. What made it worse is the lady thought it was a good compliment. She said she liked the way Mo'Nique dresses, but I wanted to ask "Why didn't you say I look like Halle Berry or Angela Basset? Why Mo'Nique?" I was nice and smiled and just said Thank you. She is really a nice lady and she wasn't trying to be hurtful, but I was crying inside....

Good point

I'm looking forward to... Getting rid of the pain in my back and joints. Being able to climb stairs without feeling like I'm about to die. Not sweating so much!! (Texas is not a place for a fat girl!) Being able to get on the floor and play with the kids without needing a crane to get me up. Being able to run with the kids for more than a few minutes at a time Being able to jog on the treadmil for more than 30 seconds Feeling like I'm not going to break the treadmill when I jog Not being so embarrassed to leave the house every day Being able to shop anywhere EXCEPT the "Woman's" section of the department stores Feeling like I am 35 instead of 105

That is so awesome!!! Congrats to you!!! I also have Cigna and I have my last Dr. visit next week and then my paperwork will be submitted. I hope Cigna works that fast for me.