Advice is greatly appreciated!

[Gotta win 4me 12]

My pcp submitted the last of everything that was required of me in this process on last Tuesday, November 27th. I called my advocate at the weight loss center and she said that she had everything she needed and she submitted it to the insurance department. Well it been officially over a week and my insurance company says that they haven’t received anything. Also, if there was something pending or approved I would be able to see it when I log into my Cigna account. There is nothing there except my approval for removal of lapband. Should I call them? If so, how should I address them? I don’t want to nag but I also don’t want to wait to long and then they say they lost my paperwork. Please advise! Thank you!

[Matt Z 4,139]

8 minutes ago, Gotta win 4me said:

My pcp submitted the last of everything that was required of me in this process on last Tuesday, November 27th. I called my advocate at the weight loss center and she said that she had everything she needed and she submitted it to the insurance department. Well it been officially over a week and my insurance company says that they haven’t received anything. Also, if there was something pending or approved I would be able to see it when I log into my Cigna account. There is nothing there except my approval for removal of lapband. Should I call them? If so, how should I address them? I don’t want to nag but I also don’t want to wait to long and then they say they lost my paperwork. Please advise! Thank you!

I don't want to sway you away from your decision... but have you been informed about the current state of the Lab-Band "world"? More and More surgeons are not installing bands due to all the complications and issues. Even 2 of the major parts manufacturers for lap-bands, have stopped or sold off their portions of the company responsible for lab-bands.

Your insurance might not even allow/cover them anymore and that might be why you are only seeing the removal listed in your information.

I would call your insurance directly and inquire as to if they even still approve/cover lab bands.

[Gotta win 4me 12]

10 minutes ago, Matt Z said:

I don't want to sway you away from your decision... but have you been informed about the current state of the Lab-Band "world"? More and More surgeons are not installing bands due to all the complications and issues. Even 2 of the major parts manufacturers for lap-bands, have stopped or sold off their portions of the company responsible for lab-bands.

Your insurance might not even allow/cover them anymore and that might be why you are only seeing the removal listed in your information.

I would call your insurance directly and inquire as to if they even still approve/cover lab bands.

Matt,

I am having a conversion from band to bypass. I have been approved for the removal of the band and they were supposed to have submitted for the RNY part on last week. Sorry, I didn’t make that clearer. I would like to know if I should call my weight loss center to inquire about them actually submitting to insurance.

Edited December 5, 2018 by Gotta win 4me

[Matt Z 4,139]

Just now, Gotta win 4me said:

Matt,

I am having a conversion from band to bypass. I have been approved for the removal of the band and they were supposed to have submitted for the RNY part on last week. Sorry, I didn’t make that clearer.

No worries! Give them a call, I wouldn't worry about "bugging" them, honestly I had to keep tabs on everyone constantly in order to make sure things were getting done in a timely manner.

[FluffyChix 17,415]

No experience to offer, just hugs. Such a nerve racking time! Congrats on the band to bypass!

[GreenTealael 25,430]

I suggest managing your time line and staying on top of everyone. Submitters and approvers are only human after all.

[Gotta win 4me 12]

Update: I have contacted them every other day since this post and NO ONE has returned a phone call or email. I don’t know who I can complain to. I’m starting to think I should find another doctor in another area.

[Briswife15 890]

I had the same problem. My patient navigator was supposed to give my file to the insurance coordinator on November 26. 2 weeks of waiting and a call to Anthem, and it had not been sent to insurance. Turns out there was som3thing the surgeon had to complete and he had been busy. They finally texted the doctor, he did it, the insurance woman finally sent it to Anthem this past Thursday. So, maybe there is a piece that still needs to be completed. I'd put it in writing and send them a letter if they won't return phone calls. Good luck, and keep us posted.

Sent from my SM-N960U using BariatricPal mobile app

[Gotta win 4me 12]

UPDATE: I contacted my doctors office again on yesterday and explained that I have been trying to get in touch with someone about my insurance submission. Apparently, it was lost so they resubmitted to the insurance and it is finally appearing on my Cigna account in progress. That set me back 3 weeks. Smh Now the wait for the approval begins.

[Briswife15 890]

I hear ya! Im waiting for insurance approval right now, too. It is hard to be patient!!

[Gotta win 4me 12]

My surgery was approved today! It took 4 days from the day they submitted. Now, on to my anxiety hurdle. Smh