IwantTHATshu

at first I had no issues with Cigna! Everything was going to smoothly and I really didn't think I was going to have any issues. I finished all my pre op visits, nutrition, I had a letter of referral from my primary doctor and a letter necessity from my surgeon, 6 months nutrition, and the only thing else I needed was a psychological evaluation, which I had done early in the game. I had my meeting with my surgeon on June 18th and they submitted everything to insurance June 20th or 21st. My surgery was scheduled for July 10th, but it wasn’t until July 6th did I hear anything for Cigna or my Doctors office in regards to approval. We received a letter saying that I still wasn’t approved! So after hours of the phone with no one being able to figure out why I wasn’t approved yet, we finally got a hold of someone named Brad who told us he got everything figured out and they were looking it over as we speak! And before he hung up he gave us the OKAY YOUR APPROVED!!...
The weekend came and went and I thought everything was all set, but I then received a call from my doctor saying I STILL wasn’t approved. So I called Cigna again and said that time they told me I was DENIED To say the least I was in tears and extremely angry that I was finding this all out THE DAY BEFORE SURGERY. Apparently they changed some things and I needed not only a referral from my doctor, but also a letter of necessity, they never received something from my surgeons office, and my psychological evaluation had to be done with in 6 months before surgery, mine was 8 months…..
Thank god I was able to pull some strings and got in to see my doctor after hours and have him to a surgery clearance and a letter, I got my psychologist to do a phone session with me and update my evaluation, and I harassed my surgeons office to figure out what the heck they were doing over there and get this mess fixed because my surgery was tomorrow.
Im sure it is partially my fault for not checking closer to the date of my surgery if everything was all set, but I cant help but put some blame on Cigna and my doctors office for both sitting on the paper work and not checking in to make sure everything was set on both ends and getting in touch with me .
I did end up having my surgery on the 10th! I got a call from my doctor’s office around 12 pm saying to head in asap I would be the last surgery of the day.
my word of advice, double, triple, and quadruple check to make sure things haven't changed on you since you started the process and that they are on their A game and are actually working to get you approved!

<p style="text-align: left; ">HI! i am so glad I found this. I had to go through a VERY similar ordeal with Cigna the DAY BEFORE surgery. I was told I was denied less then 24hrs before my surgery. So I called up and they told me I was missing that letter from my surgeon and a letter from my primary care doctor. The letter from my surgeon was a mistake on their office...</p>
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<p style="text-align: left; ">as for the primary care doctor letter, we had him write a few and none were correct. Finally the medical director at Cigna told us that the letter specifically needs to state "___ is my patient, she has (the following co-morbidities ) and 'based on my decision this patient is medically cleared for surgery'...."</p>
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<p style="text-align: left; ">again this is for what worked for us! I am hoping this will work for you. Also make sure that your psychological evaluation is as up to date as Cigna wants it to be. (we were told that it needed to be within 6 months before surgery and of course mine was 8 months...) </p>
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<p style="text-align: left; ">good luck! </p>

HI! i am so glad I found this. I had to go through a VERY similar ordeal with Cigna the DAY BEFORE surgery. I was told I was denied less then 24hrs before my surgery. So I called up and they told me I was missing that letter from my surgeon and a letter from my primary care doctor. The letter from my surgeon was a mistake on their office…
as for the primary care doctor letter, we had him write a few and none were correct. Finally the medical director at Cigna told us that the letter specifically needs to state “__ is my patient, she has (the following co-morbidities) and based on my decision this patient is medically cleared for surgery…”
again this is for what worked for us! I am hoping this will work for you. Also make sure that your psychological evaluation is as up to date as Cigna wants it to be. (we were told that it needed to be within 6 months before surgery and of course mine was 8 months.
Good luck!!

ALSO....cigna told US that the peer to peer does NOT have to be with the surgeon himself, but could be someone in his office like a nurse or for us we had the office manager talk to someone at cigna....
(sorry for posting so many times!)

Sauté fresh spinach in vegetable or chicken broth (I also threw in some garlic and shallot), when done add nonfat ricotta and a bit of Parmesan cheese and blend/purée with an immersion blender.
Spread puréed mixture in bottom of a small casserole pan and cover with prepared spaghetti sauce (no sugar added) and top with a little more Parmesan cheese. Bake until bubbly. Good for the puréed or mushy stage. I also sometimes add in a small bit of prepared pesto to kick up the flavor a bit.
Is a nice relief after all the sweet Protein shakes. My hubby says we'll use this recipe even after I back on regular food!

Also my surgeons office said Cigna is by far the most difficult to deal with. She said they like to take thier full 30 days. On the other hand I have heard people say they are trying to streamline the process. BEST OF LUCK to anyone still waiting..

I am so sorry to hear that! I was told I was dinied approvel for vsg and the hernia fix the day before my surgery! but after a lot of hard work I was able to figure out what I needed to do to get it approved and was lucky enough to have doctors that were wiling to help expidite the things I was missing.
It wasn't untill the day of surgery right before they were wheeling me to the OR did my doctor tell me that my insurance is crazy (cigna as well), but they werent going to approve the hiatal hernia...but He was nice enough to just repair it for us anyways for no cost.
I would talk to your doctor and see if there is a way he could write a letter of nessecity, also if you had an endosocopy by a seperate doctor maybe they could write something as well. It really is crazy not to cover it all togeather.