Scheduling/appointment worries

[Martene81 383]

So I'm starting to worry about getting my appointments scheduled in a timely manner. I'm in the beginning stage of the process and told myself I was not got going to worry and just go with the flow...well...yeah right!

I have Aetna and have a 3 month process to complete for insurance purposes. I'm sure we are all familiar with the process...well I'm worried because I've had my initial consultation which counts as month one visit/weigh in with the surgeon. That was on Jan. 20th. I was told I would be contacted by the navigator to schedule everything else. I decided since I had not heard anything yet, that I'd contact him myself. Well he claims has not gotten any "paperwork" from my surgeon and can't move forward until then...hmmm!

So I'm not sure about how this whole process should go but I'm worried I won't be able to get all my NUT visits, exercise visits and other appointments done within the time line required by insurance. Sorry this is so long but I don't know how all this should flow and I'd hate to miss something during this 3 months and end up getting denied in the end. I plan on having surgery at the end of May. Does anyone know what Aetna requires for appointment scheduling? Or can offer me a time line of visits that insurance will approve of?

Sorry if my post is long and confusing but I feel lost lol!

[marbelvsg 132]

I have Aetna and just finished all of my appointments. I am just waiting for insurance approval now. The day after my first meeting with my surgeon, I called and scheduled all of the appointments on my own. None of the other doctors needed any paperwork from the surgeon before they would see me. I just asked them to fax all of their reports to my surgeon.

[smile121 66]

Hi,

I have cigna, and it is a similar process to Aetna's.. I just had my first nutrition appt on January 6th, at that point my nut scheduled all of the other appts for the next 3 months, and i am scheduling all of my other appts in February. My surgeons office told me they would help with scheduling appts but i find it to be easier to do it on my own, because i have so much time. My nutritionist was affiliated with my surgeon, so they just automatically update my information. I still have to see my PCP, and get all of the blood work/ EKG/ sleep test done. All of which i am going to talk about with my PCP. Not sure if that really helps you, but I was told that I could schedule it all on my own, so that is the road i am going down.

I thought that the surgeon would file for the approval after all of the nutrition appts and other requirements were completed.

Good luck to you

Edited January 29, 2015 by smile121

[Martene81 383]

Thanks!! I did check to see if I could schedule everything myself but they said I couldn't...that they would contact me to get that done. Hopefully someone will do that soon otherwise I may not get these visits scheduled.

I'm mainly concerned with the NUT visits as I'm unsure how many insurance requires you to have.

Well good luck to you...looks like we on the same time line. When are you hoping to get surgery. I'm hoping for end of May.

[majorsmama 91]

I had my first appt with my surgeon on the 6th I think? At the end of the consult they scheduled my next nut appt and they had me walk downstairs to the psychologists office and schedule my psych eval. That's all I've gotten done yet. I don't have to have a sleep study so I believe all that's left is the ekg, blood work and endoscopy. I asked when I could schedule the endoscopy and they told me that would be later in the process. I'm not concerned about it though because these surgeons and their employees do this for a living and I'm pretty confident they've done it plenty of times before.

[vsg4missy 19]

Hi. Aetna requires 90 days which is actually 4 appts. Within that time frame you should be able to get all of your other appts completed, psych, NUT classes, etc. Best wishes.

[Jrs_lovely1 12]

Hi. I am not sure if you have done this or not but you can always follow up with the surgeons office to see if they sent the referral to the nut yet. You my have to bug them a bit but its best to do your part and stay on top of it.

I don't have CIGNA but I had similar requirements and I hassled everyone. LOL. but it got the job done especially in my case where my surgeon had just moved offices and was working with staff who had not worked with bariatric patients before. It was a learning lesson for them and I didn't want to be the "student" they dropped the ball on.

[Martene81 383]

Thank you all for the advice! I had to do a pushing but I got the ball rolling and all my appointments are booked! Now I'm just waiting to complete them all and hopefully have surgery in May!!

[Sharon1964 2,530]

Glad to hear it! I was going to tell you that the three month requirement is a minimum, not a maximum. When you said, I'm worried I won't be able to get all my NUT visits, exercise visits and other appointments done within the time line required by insurance", it sounded like you thought you had only 90 days to get it done, but that is not the case.

(sorry for being late to the party, I swore I had posted this before)

[Gr8estyaya 19]

Gastric sleeve surgery

[Gr8estyaya 19]

Does anyone have Wellmont ins or blue cross blue shield?