Just trying to srart the Sleeve process

[LuminousLife 145]

Thank you to everyone who replied to this thread with their insights! I was able to talk to my insurance it looks like they have the 6 month documented weight loss time period before the surgery it was not a year like the DR had mentioned ... Also looked into my prescription of the weight loss pills that my Dr prescribed me it is called Qysmia which has phentermine as well Topiramate' date='which is used to treat seizures with apparently ... The side effects are kinda scary mentions suicidal thoughts , and even seizures if you come off the medication too quickly so I have not gotten the prescription filled ...

So with that being said I have another appointment on Monday but with a different doctor from my medical group just to get a second opinion on the medication and more importantly the surgery! I would love any advice anyone can give me with talking to the DR about the surgery!! With my BMI alone it shouldn't be a problem I am just nervous!!! Thank you !![/quote']

You moving into he right place. I am so glad that you chose to seek a second opinion. Doctors are people and some people just can't understand the perspective of someone who has been struggling like we do. I wish you all the best we are here for you keep us posted

[peachie86 63]

I changed doctor's also because I was not happy with her responses on my health and WLS. My second dr did not agree with weight loss surgery for me at first, but after a few years and my dr becoming one of the bariatric board members she started supporting me. I was suggested to lose 10 percent of my weight, but I did not lose the whole 10 percent.

[LaurenB8604 29]

Went to a different Doctor today and she sent the referral in for bariatric surgery!! She didn't mention anything about waiting a year to lose 10 percent of my weight or anything Yay!! I know there's still a long way to go but so happy finally a doctor listened to me!! So I guess the next step is to wait for the insurance to fire a letter back of requirements or something .. Does any one know ? I am just so excited the first step of many is done !

[mazzers120 75]

Went to a different Doctor today and she sent the referral in for bariatric surgery!! She didn't mention anything about waiting a year to lose 10 percent of my weight or anything Yay!! I know there's still a long way to go but so happy finally a doctor listened to me!! So I guess the next step is to wait for the insurance to fire a letter back of requirements or something .. Does any one know ? I am just so excited the first step of many is done !

They will have you attend a bariatric seminar. There they will weigh you in and education on the process. They took my insurance info that day too. Usually bariatric teams include a group of people who just work onyour approval process

[lauri407 29]

As mazzers120 said, check out some local bariatric surgeons in your area, and go to a few seminars. They are free and will help you in figuring out insurance and other questions you may have. I went to one seminar and ended up at another practice, but I was able to use all the forms and information from the seminar to get the ball rolling. Good luck!

[LaurenB8604 29]

Hey everyone!! Thought I would just update every one on my very beginning of my weight loss journey!! So last week my doctor sent in a referral to see a bariatric surgeon! Well today I was notified by the surgeons office at Cedars Sinai in LA that they received my referral and that I could make my appointment for a consultation with the surgeon!! So today I got my appointment scheduled and my seminar both on the same day! Both scheduled on November 21!! So excited and nervous at the same time!! Would def appreciate any feedback you have

Edited November 5, 2013 by LaurenB8604

[Carmen1963 27]

Lauren - I'm not sure of what insurance you have. But Cigna will require a letter from your PCP. That states they "medically clear" you for the surgery. This exact words need to be used.

Initially my PCP wrote that he commended the WLS and I have struggled thru various weight loss programs with no long term success. It was a great letter. But Cigna still wanted another letter stating he "medically cleared" me. I wish you well!

[Andrea K 33]

Carmen- I too have Cigna (of Tennessee) and I will be seeing my PCP on Friday. I have no idea if she will be supportive of WLS or not. I have researched the hospital and surgeon I would like to use. Do I just ask her for the "Letter of Recommendation" or will she need to fax it. I don't do well with confrontation but I have educated myself about WLS and feel this is what I want to do for my health. I sure hope she will be on board with my decision.

Thanks for any help you can give.

[Carmen1963 27]

Andrea,

You can compose your letter of recommendation. Ask you insurance provider or read your plan docs for the explicit info they require from your PCP recommendation. The easiest thing to do would be to call Cigna.

I would write down the bullet points you doc needs to include in the letter for you.

It makes it easier for them and will save you time. Then have the PCP fax that letter to your bariatric surgeons insurance coordinator. It needs to be in the docs that are submitted to Cigna.

Hope this helps!

[Andrea K 33]

Carmen,

Thank you for the info. I plan on calling Cigna in the AM. I am so excited to finally get the ball rolling.

[VSG AJH 499]

Carmen- I too have Cigna (of Tennessee) and I will be seeing my PCP on Friday. I have no idea if she will be supportive of WLS or not. I have researched the hospital and surgeon I would like to use. Do I just ask her for the "Letter of Recommendation" or will she need to fax it. I don't do well with confrontation but I have educated myself about WLS and feel this is what I want to do for my health. I sure hope she will be on board with my decision.

Thanks for any help you can give.

Andrea -- I just got my approval from Cigna. My PCP had to write a letter that he both recommended me and medically cleared me for surgery. He wasn't super excited about writing it because he's a bit more of a naturopathic kind of guy, but he did it. He initially wrote it incorrectly (maybe on purpose -- ha!), but my surgeon's office called me for approval, then called him to give him the specifically required verbiage. Once everything was in, my approval process was pretty quick. Surgery December 3.

[LaurenB8604 29]

I have anthem blue cross of California, does anyone have any experiences with them ?? I go a week from Thursday for my class and than my first consultation with the Surgeon! Not sure what to expect but very exciting !!

[jennybgenius 16]

I know im late to the thread! BUT you are not alone! My doctor was not very supportive. I instead called my insurance and figure out how to do it all on my own! I luckly did not need a referal though. Sometimes you come upon glitches that are frustrating! Do not be detoured! Keep trucking along. I have a 6 month wait ahead as well! ONE STEP AT A TIME! This site is so helpful! Like minded people! We know what each other are going through!

[Andrea K 33]

Wow- just got off the phone with Cigna. They said don't worry about the letter. The Hospital I am looking into having my surgery will begin pre-certification with Cigna. They will contact my PCP and request all information that is needed. My insurance does not require my PCP to give me a referral. So if she is not on board with my decision to have WLS it will not affect anything in the process.

You all have been so great. I am so glad I came across this site.

[Mellordi 17]

Lauren, I have Anthem BC of California. My husband works for FEDEX out here in PA. let me tell you, they are a joy to work with. I called them after my info session to see if I was covered. I was. I asked them what I needed to do in order to get approved. Was told that with a BMI of lower than 40 I needed two comorbids. Needed just one over 40 BMI. I didn't need to do a doctor supervised diet. They just wanted certain tests done and a recommendation letter from my PCP. I took care of EVERYTHING Anthem wanted and then took care of all the tests my surgeon required. My whole process took just under 3 months. I was sleeved on October 22, 2013 and haven't looked back since. Good luck!!