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Re: Digest Number 1619

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Dear ,

I do not have Cigna, however my Aetna UsHealthcare has the same

exclusion as yours. You are correct when you say that Morbidly Obese

could and should be your lucky loophole, it most certainly was mine. The

first thing I did was to simply fill out the patient Info form and hit

send. (*Make a copy of it,* you will need to take one with you when you

go in for your clinic visit.) Call in a day to make sure they received

it. Barbara is wonderful but very busy as all the girls are, but they do

care! You will then get a letter back from Dr R that will be your copy of

the one he sent to the Ins Co. He'll use the info from your form but

you'll wonder why your still alive after he makes them realize how

serious our morbid obesity is. His nack at wording is fabulous! I then

went to my pcp and told her all about the surgery and I was very

fortunate that she was all for it, some are not, but she fights the fat

war and is understanding. I then called for my mammo and pap

appointments. Voila!! it was done. I had to call the Ins Co a lot.

They did start giving me the run around but I did get names and I did

use them. I went right to pre- cert dept and hooked up with a wonderful

woman there. She I feel monitored my case at the very least. I wanted

to be more than a name on a form, and I was. It takes persistence to

keep following up but do it! The biggest problem with these co's is that

they like to say things like we never received your paperwork,or, what

did you say your name was??? Well.... before I knew it after two weeks

of calling etc... Pre-cert said it was a go. If Dr R is in their

network, your chances are excellent. If the hospital is not, your pcp

has to ask for a referral saying that Dr R is the only surgeon she/he

feels can do the surgery successfully for you. And then they say ok in a

lot of cases. It does happen , just hang in there and stay on top of

everything.

Start that packet for Dr R, that takes awhile for your contacts, I did

all mine thru e-mail. Good luck and I'll be thinking of you... My

surgery is July 12th. Susie Gordon

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