!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[Guest guest]

woooooohooooooooooo !!!

CONGRATS TO YOU DINAH !!!! YEYAAAAAAA WAAAAHOOOO !

>From: dinah@...

>Reply-To: MiniGastricBypass (AT) egroups (DOT) com

>To: MiniGastricBypass (AT) egroups (DOT) com

>Subject: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

>Date: Fri, 21 Jul 2000 22:48:40 -0000

>

>I can't believe I'm approved and there is no one here to celebrate

>with!lolololol...This is too much...Okay, I just sent Bud to the

>store for honey and chocolate syrup so I guess he and I will do the

>happy dance together, without you guys! Dont' Worry, Be Happy! is

>going to be my theme song!

>

>Dinah in Alabama

>Planning!!!!!!!!!!!

>

>

>------------------------------------------------------------------------

>0% Introductory APR!

>Instant Approval!

>Aria Visa - get yours today.

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>

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>Please visit our web site at http://clos.net

>Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

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[Guest guest]

Dinah,

Oh how wonderful!!!!!!!!!!!!!!!!!!!!!!!

When did you find out? I have to call them on Monday and then they will let

me know. I want to have mine next week but looks like it might not be

til August.

in SC

Pre-op

386 lbs.

Waiting on ins. approval

If you see someone without a smile,

Give them one of yours.

If you and I should meet and

You forget me, you have lost nothing.

If you meet JESUS and you forget him,

you will have lost everything.

[Guest guest]

Hi Dinah !

Yes I am in central florida on the east coast about an hour east of

Kissimmee. I love it here and my husband works in Orlando...He wants us to

move out there...but I really dont want to raise my 5 year old little girl

out there..to big city ..I got used to the slow southern east

coast..heehe...and I came from Boston to Miami...only been here 3 years now.

I have Cigna insurance and was approved on June 17th after being denied

and having to appeal. I was soooo happy. I had my pap on 6/30, my labs

on 7/10 and my Physical and EKG on 7/14, but due to my " big girlie " 5 year

old starting kindergarten (ohhhhh gosh I still can't believe it!!) on 8/8

and a cruise booked on 8/18 I am hoping for a surgery date on 9/13. I am

awaiting the dictation of my physical and then I will send my packet to

Dr.R. Hopefully I will get it out Fed-Ex on Wed next week and Dr. R will

hopefully approve me. I am soooo excited and re-live that excitement

everytime I see one of my fellow " sisters or brothers " get approved. I

just can't wait to start my life. I have been sooo consumed by this

surgery, I will be glad when its over just so I can accomplish other things

in my life..hehehe...

When are you scheduled for surgery again?

>From: dinah@...

>Reply-To: MiniGastricBypass (AT) egroups (DOT) com

>To: MiniGastricBypass (AT) egroups (DOT) com

>Subject: Re: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

>Date: Fri, 21 Jul 2000 23:45:17 -0000

>

>Thanks , I'm just about to bust! Didn't I read a post that you

>are from a suburb of Orlando? My daughter lives in Kissimmee. She has

>been there around 4 years and loves it. I visit quite often and

>totally enjoy the drive. It is so pretty down that way. I can't

>believe I have to plan a surgery trip now instead of a clinic trip.

>Gosh. What is your status ?

>Dinah in Alabama

>!!!!!!!!!!!!!

>

>

>

>

> > woooooohooooooooooo !!!

> >

> > CONGRATS TO YOU DINAH !!!! YEYAAAAAAA WAAAAHOOOO !

> >

> >

> > >From: dinah@a...

> > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com

> > >To: MiniGastricBypass (AT) egroups (DOT) com

> > >Subject: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

> > >Date: Fri, 21 Jul 2000 22:48:40 -0000

> > >

> > >I can't believe I'm approved and there is no one here to celebrate

> > >with!lolololol...This is too much...Okay, I just sent Bud to the

> > >store for honey and chocolate syrup so I guess he and I will do the

> > >happy dance together, without you guys! Dont' Worry, Be Happy! is

> > >going to be my theme song!

> > >

> > >Dinah in Alabama

> > >Planning!!!!!!!!!!!

> > >

> > >

> > >-------------------------------------------------------------------

>-----

> > >0% Introductory APR!

> > >Instant Approval!

> > >Aria Visa - get yours today.

> > >http://click.egroups.com/1/7102/3/_/453517/_/964219729/

> > >-------------------------------------------------------------------

>-----

> > >

> > >This message is from the Mini-Gastric Bypass Mailing List at

>Onelist.com

> > >Please visit our web site at http://clos.net

> > >Get the Patient Manual at http://clos.net/get_patient_manual.htm

> > >

> > >To Unsubscribe Send and Email to:

> > >MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> > >

> > >

> >

> >

>______________________________________________________________________

>__

> > Get Your Private, Free E-mail from MSN Hotmail at

>http://www.hotmail.com

>

>

>------------------------------------------------------------------------

>To email plain text is conventional, to add graphics is divine.

>We'll show you how at www.supersig.com.

>http://click.egroups.com/1/6820/3/_/453517/_/964223337/

>------------------------------------------------------------------------

>

>This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

>Please visit our web site at http://clos.net

>Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

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________________________________________________________________________

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[Guest guest]

I can't believe I'm approved and there is no one here to celebrate

with!lolololol...This is too much...Okay, I just sent Bud to the

store for honey and chocolate syrup so I guess he and I will do the

happy dance together, without you guys! Dont' Worry, Be Happy! is

going to be my theme song!

Dinah in Alabama

Planning!!!!!!!!!!!

[Guest guest]

Dinah,

Maybe on your next trip we can arrange to meet and share MGB stories !!

>From: dinah@...

>Reply-To: MiniGastricBypass (AT) egroups (DOT) com

>To: MiniGastricBypass (AT) egroups (DOT) com

>Subject: Re: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

>Date: Sat, 22 Jul 2000 02:45:59 -0000

>

>,

>I'm not able to schedule yet because I haven't received

>the " official " approval yet. I have just a few more details to

>handle. I will have to wait for the letter to set a date and because

>of conflict with work I may have to wait til September also. I hope

>to go in August though. I'll keep you posted. I hope everything works

>for you too. I remember when my little one started kindergarten. I

>was so proud of her but I missed her sooo much during the day! Now

>she is 28 years old and I have a little grandson who is two. I go to

>Kissimmee often to visit him.

>Dinah in Alabama

>

>

>

> > > > woooooohooooooooooo !!!

> > > >

> > > > CONGRATS TO YOU DINAH !!!! YEYAAAAAAA WAAAAHOOOO !

> > > >

> > > >

> > > > >From: dinah@a...

> > > > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com

> > > > >To: MiniGastricBypass (AT) egroups (DOT) com

> > > > >Subject: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

> > > > >Date: Fri, 21 Jul 2000 22:48:40 -0000

> > > > >

> > > > >I can't believe I'm approved and there is no one here to

>celebrate

> > > > >with!lolololol...This is too much...Okay, I just sent Bud to

>the

> > > > >store for honey and chocolate syrup so I guess he and I will

>do the

> > > > >happy dance together, without you guys! Dont' Worry, Be

>Happy! is

> > > > >going to be my theme song!

> > > > >

> > > > >Dinah in Alabama

> > > > >Planning!!!!!!!!!!!

> > > > >

> > > > >

> > > > >---------------------------------------------------------------

>----

> > >-----

> > > > >0% Introductory APR!

> > > > >Instant Approval!

> > > > >Aria Visa - get yours today.

> > > > >http://click.egroups.com/1/7102/3/_/453517/_/964219729/

> > > > >---------------------------------------------------------------

>----

> > >-----

> > > > >

> > > > >This message is from the Mini-Gastric Bypass Mailing List at

> > >Onelist.com

> > > > >Please visit our web site at http://clos.net

> > > > >Get the Patient Manual at

>http://clos.net/get_patient_manual.htm

> > > > >

> > > > >To Unsubscribe Send and Email to:

> > > > >MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> > > > >

> > > > >

> > > >

> > > >

> >

> >_____________________________________________________________________

>_

> > >__

> > > > Get Your Private, Free E-mail from MSN Hotmail at

> > >http://www.hotmail.com

> > >

> > >

> > >-------------------------------------------------------------------

>-----

> > >To email plain text is conventional, to add graphics is divine.

> > >We'll show you how at www.supersig.com.

> > >http://click.egroups.com/1/6820/3/_/453517/_/964223337/

> > >-------------------------------------------------------------------

>-----

> > >

> > >This message is from the Mini-Gastric Bypass Mailing List at

>Onelist.com

> > >Please visit our web site at http://clos.net

> > >Get the Patient Manual at http://clos.net/get_patient_manual.htm

> > >

> > >To Unsubscribe Send and Email to:

> > >MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> > >

> > >

> >

> >

>______________________________________________________________________

>__

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>

>------------------------------------------------------------------------

>Remember four years of good friends, bad clothes, explosive chemistry

>experiments.

>http://click.egroups.com/1/7077/3/_/453517/_/964233964/

>------------------------------------------------------------------------

>

>This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

>Please visit our web site at http://clos.net

>Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

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________________________________________________________________________

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[Guest guest]

Thanks , I'm just about to bust! Didn't I read a post that you

are from a suburb of Orlando? My daughter lives in Kissimmee. She has

been there around 4 years and loves it. I visit quite often and

totally enjoy the drive. It is so pretty down that way. I can't

believe I have to plan a surgery trip now instead of a clinic trip.

Gosh. What is your status ?

Dinah in Alabama

!!!!!!!!!!!!!

> woooooohooooooooooo !!!

>

> CONGRATS TO YOU DINAH !!!! YEYAAAAAAA WAAAAHOOOO !

>

>

> >From: dinah@a...

> >Reply-To: MiniGastricBypass (AT) egroups (DOT) com

> >To: MiniGastricBypass (AT) egroups (DOT) com

> >Subject: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

> >Date: Fri, 21 Jul 2000 22:48:40 -0000

> >

> >I can't believe I'm approved and there is no one here to celebrate

> >with!lolololol...This is too much...Okay, I just sent Bud to the

> >store for honey and chocolate syrup so I guess he and I will do the

> >happy dance together, without you guys! Dont' Worry, Be Happy! is

> >going to be my theme song!

> >

> >Dinah in Alabama

> >Planning!!!!!!!!!!!

> >

> >

> >-------------------------------------------------------------------

-----

> >0% Introductory APR!

> >Instant Approval!

> >Aria Visa - get yours today.

> >http://click.egroups.com/1/7102/3/_/453517/_/964219729/

> >-------------------------------------------------------------------

-----

> >

> >This message is from the Mini-Gastric Bypass Mailing List at

Onelist.com

> >Please visit our web site at http://clos.net

> >Get the Patient Manual at http://clos.net/get_patient_manual.htm

> >

> >To Unsubscribe Send and Email to:

> >MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> >

> >

>

>

______________________________________________________________________

__

> Get Your Private, Free E-mail from MSN Hotmail at

http://www.hotmail.com

[Guest guest]

how long have you been waiting on insurane approval??

Re: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

> Dinah,

> Oh how wonderful!!!!!!!!!!!!!!!!!!!!!!!

> When did you find out? I have to call them on Monday and then they will

let

> me know. I want to have mine next week but looks like it might not be

> til August.

>

> in SC

> Pre-op

> 386 lbs.

> Waiting on ins. approval

>

> If you see someone without a smile,

> Give them one of yours.

>

> If you and I should meet and

> You forget me, you have lost nothing.

>

> If you meet JESUS and you forget him,

> you will have lost everything.

>

> ------------------------------------------------------------------------

> To email plain text is conventional, to add graphics is divine.

> We'll show you how at www.supersig.com.

> http://click.egroups.com/1/6820/3/_/453517/_/964227094/

> ------------------------------------------------------------------------

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

>

[Guest guest]

, actually is the one who did the talking. She talked

directly to them and all I have to do is send in my physical from my

pcp and a letter from her and they said they would approve me. I will

have my pcp do that Monday and fax it to them. She talked to them

about all the bcbs of al group I think. She said she would post to

the board tonight and send out individual e-mails. She e-mailed me

while ago and said I wasn't exactly " approved " but it was as good as.

Anyway I'm taking it as approved, he said I had the comorbidities and

it looked as if it was medically necessary. The best part is I don't

have to go to NC twice. I'm sorry that you and the others had to go

to that expense, although I know ya'll enjoyed the clinic and meeting

everyone. I just can't afford the extra expense right now. I hope

posts or e-mail you tonight. Let me know.

Dinah in Alabama Beaming!

> Dinah,

> Oh how wonderful!!!!!!!!!!!!!!!!!!!!!!!

> When did you find out? I have to call them on Monday and then they

will let

> me know. I want to have mine next week but looks like it might

not be

> til August.

>

> in SC

> Pre-op

> 386 lbs.

> Waiting on ins. approval

>

> If you see someone without a smile,

> Give them one of yours.

>

> If you and I should meet and

> You forget me, you have lost nothing.

>

> If you meet JESUS and you forget him,

> you will have lost everything.

[Guest guest]

,

I'm not able to schedule yet because I haven't received

the " official " approval yet. I have just a few more details to

handle. I will have to wait for the letter to set a date and because

of conflict with work I may have to wait til September also. I hope

to go in August though. I'll keep you posted. I hope everything works

for you too. I remember when my little one started kindergarten. I

was so proud of her but I missed her sooo much during the day! Now

she is 28 years old and I have a little grandson who is two. I go to

Kissimmee often to visit him.

Dinah in Alabama

> > > woooooohooooooooooo !!!

> > >

> > > CONGRATS TO YOU DINAH !!!! YEYAAAAAAA WAAAAHOOOO !

> > >

> > >

> > > >From: dinah@a...

> > > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com

> > > >To: MiniGastricBypass (AT) egroups (DOT) com

> > > >Subject: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

> > > >Date: Fri, 21 Jul 2000 22:48:40 -0000

> > > >

> > > >I can't believe I'm approved and there is no one here to

celebrate

> > > >with!lolololol...This is too much...Okay, I just sent Bud to

the

> > > >store for honey and chocolate syrup so I guess he and I will

do the

> > > >happy dance together, without you guys! Dont' Worry, Be

Happy! is

> > > >going to be my theme song!

> > > >

> > > >Dinah in Alabama

> > > >Planning!!!!!!!!!!!

> > > >

> > > >

> > > >---------------------------------------------------------------

----

> >-----

> > > >0% Introductory APR!

> > > >Instant Approval!

> > > >Aria Visa - get yours today.

> > > >http://click.egroups.com/1/7102/3/_/453517/_/964219729/

> > > >---------------------------------------------------------------

----

> >-----

> > > >

> > > >This message is from the Mini-Gastric Bypass Mailing List at

> >Onelist.com

> > > >Please visit our web site at http://clos.net

> > > >Get the Patient Manual at

http://clos.net/get_patient_manual.htm

> > > >

> > > >To Unsubscribe Send and Email to:

> > > >MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> > > >

> > > >

> > >

> > >

>

>_____________________________________________________________________

_

> >__

> > > Get Your Private, Free E-mail from MSN Hotmail at

> >http://www.hotmail.com

> >

> >

> >-------------------------------------------------------------------

-----

> >To email plain text is conventional, to add graphics is divine.

> >We'll show you how at www.supersig.com.

> >http://click.egroups.com/1/6820/3/_/453517/_/964223337/

> >-------------------------------------------------------------------

-----

> >

> >This message is from the Mini-Gastric Bypass Mailing List at

Onelist.com

> >Please visit our web site at http://clos.net

> >Get the Patient Manual at http://clos.net/get_patient_manual.htm

> >

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> >

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>

______________________________________________________________________

__

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[Guest guest]

Hi , I was turned down by Cigna on Thursday, if you would, could you

tell me what their reason was for the denial. Mine told me that my employer

chose not to offer this benefit to their employees. They will cover weight

loss but not weight loss surgery.

Very disappointed

Irene

BMI 42

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

> > > >Date: Fri, 21 Jul 2000 22:48:40 -0000

> > > >

> > > >I can't believe I'm approved and there is no one here to celebrate

> > > >with!lolololol...This is too much...Okay, I just sent Bud to the

> > > >store for honey and chocolate syrup so I guess he and I will do the

> > > >happy dance together, without you guys! Dont' Worry, Be Happy! is

> > > >going to be my theme song!

> > > >

> > > >Dinah in Alabama

> > > >Planning!!!!!!!!!!!

> > > >

> > > >

> > > >-------------------------------------------------------------------

> >-----

> > > >0% Introductory APR!

> > > >Instant Approval!

> > > >Aria Visa - get yours today.

> > > >http://click.egroups.com/1/7102/3/_/453517/_/964219729/

> > > >-------------------------------------------------------------------

> >-----

> > > >

> > > >This message is from the Mini-Gastric Bypass Mailing List at

> >Onelist.com

> > > >Please visit our web site at http://clos.net

> > > >Get the Patient Manual at http://clos.net/get_patient_manual.htm

> > > >

> > > >To Unsubscribe Send and Email to:

> > > >MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> > > >

> > > >

> > >

> > >

> >______________________________________________________________________

> >__

> > > Get Your Private, Free E-mail from MSN Hotmail at

> >http://www.hotmail.com

> >

> >

> >------------------------------------------------------------------------

> >To email plain text is conventional, to add graphics is divine.

> >We'll show you how at www.supersig.com.

> >http://click.egroups.com/1/6820/3/_/453517/_/964223337/

> >------------------------------------------------------------------------

> >

> >This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> >Please visit our web site at http://clos.net

> >Get the Patient Manual at http://clos.net/get_patient_manual.htm

> >

> >To Unsubscribe Send and Email to:

> >MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> >

> >

>

> ________________________________________________________________________

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> Life's too short to send boring email. Let SuperSig come to the rescue.

> http://click.egroups.com/1/6809/3/_/453517/_/964230575/

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[Guest guest]

Hi Irene !

I have Cigna Healthcare of Florida PPO. It is thru my husband's employer,

he is a store manager for Zales Jewelers. I did things a bit backwards I

think. I believed that if I got my insurance approval first it would save

DrR's office a step and move things a bit faster, I do not believe that this

was the correct way, I often wonder if I had just let DrR's office send the

letter if I would have been approved first time around, but someone once

told me that sometimes its their way of weeding the not so serious folks

out. It was my PCP who told me about DrR and recommended that I have the

surgery. He typed up a letter and sent it to Cigna (it was only about 1

paragraph long and not very detailed.) I got a call the next day from his

ofc saying that Cigna wanted more info on the diets that I had tried and

failed at. I was very frustrated and the girl at the ofc was very young and

had zero sense of urgency, she hadn't a clue how important this was. She

typed one thing I had said and sent it to Cigna. Cigna denied me the next

day due to a " lack of medical necessity " Well let me tell you, I am 30 yrs

old, 5'1, 297lbs (well i'm now 289, I've lost a few lbs since then) and my

BMI is 55%. I have at least three comorbitites and was absolutely stunned

that I was denied for this reason. I never EVER thought I would be denied

for the surgery, I did believe that I would have a fight to have it done

with DrR. in NC. I called Cigna member services and a CSR named Rhonda

helped me tremendously. She explained all of the different levels of

appeals, and what type of " board " reviews the appeals. She said that at

every stage there are completely different board members that review, so

that you have a totally unbiased decision. She also told me that the first

request is reviewed by a doctor, and based soley on medical necessity. The

first appeal board looks at it from a personal view, and told me to make my

appeal letter VERY personal. She stressed VERY personal. I was denied the

initial request on May 16th and it took me until June 14th to get my appeal

letter ( it was more a manual, it was 134pgs long) together and Fed-Ex'd to

them. I received a call three days later at work telling me I was

approved. My appeal letter was 8 pages long, single spaced and typed. I

began with how pleased I've always been with my coverage with Cigna and what

my life is like today. I then went back to the time I was 3, which for me

is when I began gaining weight at a very rapid weight. I told them about

each and every single diet, excercise, pill, shake, shot and meditation that

I had tried and failed at. In the denial letter I received, they outlined

what they consider to be a medically necessary candidate for consideration.

I met and EXCEEDED every single thing, and specifically addressed this by

typing this in bold, extra dark, outlined, italicized letters. After the

letter was DrR's 14 page letter that after I had read it even I thought I

was ready to be laid to rest !!! hehehehe, his use of words were amazing,

and I then put my PCP's letter of recommendation, all of my medical records

from the last three years with the same PCP that is referring me, I printed

many articles from obesity.com regarding the cost that insurance companies

pay to treat the obese, I printed the NIH's " Rationale for the surgical

treatment of Morbid Obesity " (this is on DrR's website from what I

understand, I had no idea until just recently. I showed them the

comorbities that are statistical certainties that they will have to pay for

the rest of my life, let alone the cost of the gal bladder surgery, the

heart attack and everything else i'm destined to develope. I then compared

that to the cost of the MGB. I also let them know that I know of at least

two others that were approved by Cigna for this surgery, one of whom was

here in Florida. I was approved three days after they received this, and

received the call from the Administrator herself, commending me on the job I

did on my appeal letter (manual). She said it was obvious how much effort

and hard work I had put into this. I had 30 days to appeal this denial and

it took me almost 28 days to put it all together. But for the first time

in my life I stuck with it, and did not take no for an answer. It is for

this reason that I know deep in my heart and soul that this is the right

thing for me.

If there is ANYTHING I can do for you, ANYTHING please feel free to email me

or call me at .

>

>Reply-To: MiniGastricBypass (AT) egroups (DOT) com

>To: <MiniGastricBypass (AT) egroups (DOT) com>

>Subject: Re: Re: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

>Date: Sat, 22 Jul 2000 09:10:49 -0400

>

>Hi , I was turned down by Cigna on Thursday, if you would, could you

>tell me what their reason was for the denial. Mine told me that my

>employer

>chose not to offer this benefit to their employees. They will cover weight

>loss but not weight loss surgery.

>Very disappointed

>Irene

>BMI 42

> Re: Re: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

>

>

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[Guest guest]

In a message dated 7/22/2000 2:27:21 PM Eastern Daylight Time,

dreamscape3@... writes:

<< " The CIGNA HealthCare of North Carolina, Inc., Health Services

Department, has received a reques on you behalf for Gastric Bypass Surgery.

After careful review of the information submitted, it has been determined

that this request is denied because this is not covered under your group

health benefit plan (see Member Certificate page 18, Item " KK " ). >>

Hi Irene,

You must be my twin!!! I'm also 5 feet tall, weigh 216 lbs., have BMI

of 42. My Insurance, United Healthcare of NC also denied me as saying there

is an exclusion for " weight loss surgery " . The difference is my letter told

me I can't appeal it which I don't understand. I thought all Insurance co.

had an appeal process, so I am now at a loss at what I'm supposed to do. I

guess try and save up the money to self pay, unless there is someone out here

who can advise me on a different recourse. I wish you luck on fighting

them!!!!!!!!!

Cathy in Lenoir, NC

Pre-op

BMI 42

A journey of a thousand miles begins with a single step

[Guest guest]

,

First let me thank you for getting back to me so soon. This is a

great avenue to express feelings and to explore questions.

I think your experience with the ins. co. is a great inspiration. I

don't think I have quite the same problem. Hopefully someone can offer me

some input into my situation. As follows:

I am a 36 year old female, I have been overweight all my life, or at

least since puberty. I am 5ft tall and weigh 216lbs, giving me a BMI of 42.

My PCP refered me to Dr. R after struggling to lose weight for the 18 years

that I have been her patient. Before that I'd never heard of the MGB.

I made my consultation/meeting on 7/18/00. I was very impressed with

the procedure and Dr. Rutledge. He approved me and sent me home to do my

" homework " . Two days later I called the ins.co. and found out they didn't

receive my request for preapproval (no suprise). I faxed them a copy. Two

hours later I called to confirm that it was received. It was and they said

I was denied. I got the letter that says:

" The CIGNA HealthCare of North Carolina, Inc., Health Services

Department, has received a reques on you behalf for Gastric Bypass Surgery.

After careful review of the information submitted, it has been determined

that this request is denied because this is not covered under your group

health benefit plan (see Member Certificate page 18, Item " KK " ).

I am sorry that this decision could not be more favorable. If you have

further information that might affect the outcome of this decision, you can

appeal by providing that additional information accompanied by a letter

:........yada yada.......

I read the item they said to, it amounts to: we cover weight loss but

not weight loss surgery.............

I am trying to appeal through my Human Resources Dept. I work for

Eckerd Drugs..........

Help!!!!!!

Irene

BMI 42

Wanna-be MGB

Re: Re: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

> >

> >

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