4/21/03 Well another week has gone by and nothing new to report, hoping everything is submitted to insurance company this week and a quick approval to come. Then maybe an earlier surgery dates to start my new and challenging life with WLS. At this stage of this process I hope and wish that other family members should consider this option for their health and well being (Jessica & Dianna). The past couple of weeks my body has been in a lot of pain/tired not able to do a lot of things, it’s like I have hit a brick wall. I lack all energy and my weight is getting to me, however I see the light at the end of this tunnel with WLS and a better and longer life to spoil my grandkids. Now to the work front, another position to come open shortly in my department due to the departure of a co-worker, I have been somewhat told that I won’t be selected for the position (yet I have been doing this job 3 Years.). It’s like every position that I have tried for the requirements is raised each time higher or you’re not a strong candidate and hire outside the company. The past 3 years I have been the supervisor of the Asset Protection Dept. – Las Vegas office, with a contract staff of 43 officers, over 30 + building in the valley, plus support other site in the western region and not paid properly for that position. I feel it boils down to my weight and appearance. The new Specialist Position will be located in Las Vegas which means a step down in what I will be doing and responsibilities, basically a slap in the face for a job well done and the bad part of this is I have put 14 years with this company.
4/30/03 Well got a confusing phone call from Surgical Weight loss office today about my Company and Cigna’s coverage for WLS. I was informed that with indemnity coverage I’ll have to pay for the doctor potion up front, which is $7500.00. I immediately call Cigna customer service to research what was going on and if something has change on our policy. A Long story – short, my policy is not an indemnity plan, Dr. Fisher is contracted with Cigna – MCC and my plan is a PPO with a co-pay for the hospital of $250.00 and doctor’s fee are covered with a co-pay for office visits. They really got my heart pumping with that news of pay the doctor fee prior to surgery.
Today my wife and I found old Jenny Craig records dating back to 1992 that cover more than 12 weeks worth of diet history. I drove to the doctor’s office to turn-in additional information for my case, they were in the process of submit my paperwork to insurance company. So hopefully we will get a quick approval and my date moved up sooner. While at the doctor’s office I step on the scale it showed 466 pounds, I’ve gained 11 pounds in little over 2 weeks?????
5/11/03 Happy Mother's Day to all. Things are still moving along slowly, we found out that my paperwork - 52 pages was not sent into the insurance company until Monday the 5th and needed to be faxed again to a different department on Wednesday. We will check with them on Wednesday for an update. My wife and I found my discharge papers from the military with the weight control program attached, I put in for early discharge due to weight problems and problems with a Senior NCO who was on my case and was attempting legal action. You see I was constantly on/off the weight program for a couple of years and was banned from promotions and other things due to this problem. Now 17 years latter and double the weight it seems I have the same type of problem brewing, inappropriate comments were made to me this past week from an upper management. All I can say is a year from now things will be different for me, my appearance and weight will change, but my work & personnel ethics will be the same as always. It's a shame that people can not see past these issues! Well need to get back to the books, studying for a certification test with ASIS - "Physical Security Professional" which I will be taking on July 19th depending on surgery and recovery time.
5/16/03 First letter to Cigna (52 Pages) was denied this morning, no reason has been given at this time. This denial actually came from there manage care provider for Cigna and come to find out they have a higher guidelines for this type of surgery. The doctor’s office also got nowhere with finding out why and would have to wait for the letter. Once everyone has seen the reason there could be a Doctor to Doctor review of the case with there manage care provider. When I called Cigna to verify guidelines and to get a printed copy, they were stated differently to me than previously explained. So I have heard 3 different versions of guidelines, I stated to the representative that they have a problem and explained my case. At which time she seen the denial on her computer without any reasons stated, she then brought it to her supervisor attention and stated they would bring it to there review boards attention on Monday and call me on this matter. A co-worker’s daughter has been going through the process for approval on Lap-band surgery, she received her denial letter on Tuesday. Her denial was for lack of diet history, they were looking for 2 diets for 26 weeks long. Nothing but delay tactics and finger pointing, I will fight this all the way even if I have to go court.
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