Actually, I've called Cigna 10 or 11 times to confirm the 3 months of supervised weight loss visits and its just that 3 CONSECUTIVE months. The link you listed specifically says if the procedure is FOLLOWING SIGNIFICANT weight loss, THEN you need 6 months of documented STABLE weight. ***Here:Note: If the procedure is being performed following significant weight loss, in addition to meeting the
criteria noted above, there should be evidence that the individual has maintained a stable weight for at
least six months. If the weight loss is the result of bariatric surgery, panniculectomy should not be
performed until at least 18 months after bariatric surgery and only when weight has been stable for at
least the most recent six months.
I specifically called Cigna yesterday and spoke directly with a lady from the pre-determination department at Cigna and here is the criteria that is need for Cigna to approve you for weight loss surgery:
-3 consecutive months of a supervised weight loss program (must be supervised by a doctor or registered dietitian) (following MUST be documented: a weight loss program, an exercise program, weight at visit)
-Letter of medical necessity from your Primary Care Physician (the following needs to be documented:Height, weight,BMI, comorbidities (example:diabetes, hypertension, etc..), and daily medications)
-Psychological evaluation by a mental health provider
-Nutritional consult done by a doctor or registered dietitian
-Medical clearance from your Primary Care Physician (stating you are cleared for surgery)
-Eval by Bariatric Surgeon