And So It Begins...waiting On Insurance Approval

[Jim1967 3,569]

Thank you. They are submitting additional documentation today so hopefully that will do it.

[lisaholland73 197]

I'm rooting for you!!

[Kerra 4]

Hey Jim! I think I know you... Same post on the LGH site I think we are the only ones active over there. Lol they will get it straightened out. I am sure of it!

[Jim1967 3,569]

Yep that's me. Nancy is working on it and told me not to worry she deals with this all the time. It might just take a bit longer.

[markfaz66 0]

Jim,

Keep trying, wishing you the best of luck!

[Jim1967 3,569]

Wow I am really bummed....

I got a call from the Center yesterday and they told me my Surgeon spoke directly with the doctor at Cigna and got shot down stating there is no medical necessity. Seriously? I know I am very healthy considering my 455 pound frame but c'mon!! I guess I need diabetes or high blood pressure to convince them? Or better yet a heart attack? but I may not survive that. I watched my father live through that and it wasn't pleasant.

Sorry for the rant and pity poor me party but I am just frustrated. I have done everything asked of me. I went to all the support classes and took a binge eaters 6 week support program. Changed my eating ways and dropped 32 pounds. I have passed all the preop testing with flying colors and was checked and probed by a 3rd party doctor who told me I have to be the healthiest overweight person he's ever met...

[mandagay 93]

U r 455 and they turned u down? U need to keep appealing with stats about obesity ie. joint break down, heart attacks (as u mentioned) sleep apnea etc. it's amazing u have normal numbers on ur blood work but u need to also state the great risk of diabetes, high bp and such. I'm sure I'm just repeating everything already running thru your mind but I used to collect from ins companies and I know that the squeaky wheel gets the grease!! Good luck and don't give up!!

[Jim1967 3,569]

Oh yea...forgot to mention I do have sleep apnea. They know all that as well. I have gotten so used to sleeping with my CPAP that I sometimes forget why I have it. If that makes sense.

We are appealing. We are providing them more documentation along with food journals and exercise activity. Thankfully the Center I am working with is a great advocate. I was impressed that my actual surgeon took the time and made the call on my behalf and didn't staff it out. They're going above and beyond in my eyes.

[Kerra 4]

Oh Jim that it is just horrible! Considering you have sleep apnea, and clearly a family history since your dad had a heart attack, that is just unbelievable that Cigna is still denying. These insurance companies, I tell ya!

[Jim1967 3,569]

Approved!!

Monday I was denied and this morning I got the call stating the approval is in. 5 months worth of food journals and exercise logs finally won them over. Thanks to all of you for mojo I really needed it. It's been a long week but now I am starting off the weekend with a bang!!

Surgery date is April 16

[colleenjoy 104]

Congrats! Finally the insurace company got it right. I hope everything goes smoothe with your surgery.

[lisaholland73 197]

Approved!!

Monday I was denied and this morning I got the call stating the approval is in. 5 months worth of food journals and exercise logs finally won them over. Thanks to all of you for mojo I really needed it. It's been a long week but now I am starting off the weekend with a bang!!

Surgery date is April 16 <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/rolleyes.gif' class='bbc_emoticon' alt='' />

Congrats you are the day before me! We can do it!!!

[Imanurse 27]

that's awesome news! congrats =)

healthygal73 ~ Sent from my iPad using LBT

[RoniB 13]

You & I are in the same boat. My paperwork was submitted on the 28th. I am a nervous wreck. Anxious, antsy, trouble sleeping.... this is as bad as waiting for my son to be born 22 yrs ago!!! My insurance is United Health Care/Secure Horizons AARP Medicare Advantage. They say it could take them 2 weeks - arggggggggg

Will be interesting to see which of us hears first.

Hugs,

Roni

[daisychains7 427]

Congrats, Jim! I'm happy for you. After a difficult road to approval you must be relieved.

My doctor submitted me to insurance on the 28th as well. They said it will take two weeks to hear back. For the first time on this journey I am an emotional wreck. Irritable, anxious and barely sleeping (but also excited). Is this normal? Haha