Question about 6 months...

laurenwhite82 · 06-07-2008, 04:51 PM

So im starting to get close to the end and thinking about every possible thing that could go wrong....yes, bad attitude, i know, but im just trying to be prepared for anything. I have Cigna and was required to do the 6 month pre op appointments. I am in my 5th month right now, but when I look back over my dates of my visits I wonder if this will be a problem. My first appointment was Feb. 1st. Ive been trying to go at the beginning of every month but this month I ended up going on the 2nd (counting as my 5th month appointment) and am going again on the 30th (counting as my 6 month appt). Do any of you know whether my insurance will consider the dates too close together or will they say I am missing a month since I technically wont be going for the month of July?? I know my dr will move the date up if needed, but Id like to get an idea if this will be a problem so I can talk to her about it beforehand. I am being banded at NYU so I plan on asking the patient liason there as well, but I thought Id see if anyone here has had any experience with this. Thanks!

emily111 · 06-07-2008, 05:07 PM

my patient advocate told me that some insurance requires that you count 30 days in between each apt. thank goodness they did not have that in mine. I would call the insurance company ask them about that and get them to mail you a copy of the requirements to get approved this is what I did. I am in my 6 month I will have my 6th appt. in a week. I am like you freaking out lol thinking what could go wrong.

It's_Christine · 06-07-2008, 05:08 PM

Something similar happened to me with my supervised diet phase. My insurance was not as strict about the timing as they were about the fact that I had to lose at least 5% of my body weight and show that I could follow a 1200-1500 calorie eating plan.

Good luck...the waiting is the worst part!

laurenwhite82 · 06-07-2008, 05:12 PM

Thanks for responding! I have the requirements and theres nothing specific said about that. Just says I have to have 6 consecutive appointments and a surgical clearance. I already talked to my PCP and told her I was worried it might be a problem. She said they usually arent that strict about the exact dates (she has helped a lot of people get banded), but if she needed to, she would play with the dates for me. I plan on asking the insurance people at NYU and seeing what they say. Just dont want any problems...ya know! You are right....waiting is the worst part!

Carrie_C · 06-08-2008, 02:36 PM

I don't think you will have a problem with the dates. I have Cigna as well. They weren't that picky with mine. But the doctor said Cigna expects a 10% weight loss with the 6 months plan. But all pans may not be the same.

wsw27 · 06-08-2008, 10:35 PM

I have CIGNA too. Am also planning to have surgery at NYU (tentative date -- July 1). I've been told that CIGNA is very picky. I would move the appointment so that is falls in the next month. If paperwork shows two appts in the same month, they may not get past that fact. I am awaiting insurance approval too so this really speculation on my part, but the folks at NYU have told me how difficult CIGNA can be about the paperwork.

laurenwhite82 · 06-09-2008, 12:22 PM

Thanks for all the responses....still trying to get ahold of the patient liason at NYU (shes a very busy woman apparently), but I think I will go ahead and ask my dr. to have the dates reflect one appointment a month just to be on the safe side.

Froggi · 06-09-2008, 12:34 PM

I have 12 appts total 2 appts a month 1 every 2 weeks. I don't have the insurance you guys have. my insurance just told me 6 months of supervised diet.

laurenwhite82 · 06-09-2008, 12:37 PM

I only had to have one appt a month, but, if we are really getting down to technicalities here, some months I had one at the beginning of the month and one at the end (one on the 1st and one on the 31st). I just dont know how big of jerks Cigna is gonna try to be.

Froggi · 06-09-2008, 12:47 PM

Hope they aren't jerks. Just think positive, I am sure things will go fine. I keep worrying my insurance is going to draw things out longer and longer and make it to where I can't get my surgery before December 31st, when it's supposed to be in November. I am turning 23 and get kicked off the insurance at the end of the year, so I am hoping everything goes in my favor. I sometimes wish I wasn't turning 23 on august 7th, but I can't stop it from happening. All I can do is hope and believe and think positively about everything going smoothly and my surgery being in November like it should.

laurenwhite82 · 06-09-2008, 01:06 PM

Good luck to you! The waiting is the hardest part! Hope they arent jerks to you too.

Froggi · 06-09-2008, 01:09 PM

I sure hope things go okay, The other day i was at one of my nutrition appts and the nurse comes up to me says. Well we got a letter from your insurance requesting even more testing than we required from what we learned about your medical history. It's so frustrating that they want to draw things out longer and longer. The nurse is trying to get ahold of them and tell them I don't need the extra testing. I hope things turn out well for both of us.

Carrie_C · 06-09-2008, 06:44 PM

I heard that Cigna has changed their requirements, so you might want to find out.