Dallas_P

I was told that it's the weight that you start at with your first surgeon's visit that Cigna goes by but I've wondered the same thing. My starting BMI was over 40 and I had two co-morbidities that were well documented. Cigna never questioned the co-mordities because at a BMI of 40 I didn't need them Read you approval level when you get it. It's very confusing and in one paragraph they say your approved and in the next they say that the letter is not an approval and your approval is determined by facts on the date of surgery. As a precautionary note I have decided not to drop to a BMI of 35 or below just in case. My current BMI is now just a little over 37 down from 41 but I will not risk having to pay for this myself by being too successful on my pre surgical diet. I would also advise having a 4th meeting with your nutritionist or dietician. That way there is no doubt that you have been under a supervised weight loss plan for more that 89 days. Cigna is a stickler about the 89 day rule.

Congratulations on your quick approval. What I found out about Cigna is that the approval timeframe depends on 1. your specific plan 2. The hospital in which you will have the surgery 3. Whether your procedure is listed as in house our outpatient. I did not know any of this in the beginning but learned throughout the process. I had to wait the full 30 days only to be told I was not approved. I found out if your procedure is going to require an overnight stay then the approval process is 5 days and receives priority consideration. My insurance coordinator told me that my hospital required all procedures to be listed as outpatient with 23 hours of observation (so an overnight stay is possibly included) but the process took the full 30. I even called the morning of the 30th day to see if I was approved and they told me that they would let me know at the end of the day. At 4:30 that afternoon I was denied, I appealed and won my appeal in about 15 days so don't be afraid to push back on Cigna if denied. They told me I was missing two letters which were in the file. It's a frustrating process but worth it for the reward of getting approval. I'm glad to hear that you got such a fast approval and wish you the best of luck and success with your surgery.

My name is Dallas and I live in Royse City. I work in North Dallas. I just turned 60 in March. I'll be having the VSG on July 31, 2014 at Baylor Plano by Dr. Nick Nicholson. Starting weight 311. Current weight 274. Goal weight 175. Height 6'0. Lost most of the pre surgical weight using Optifast shakes. I'm looking forward to talking with fellow Texans and sharing experiences both pre and post op. The first surgeon that I talked to told me that my demographic (male, >60) had the highest failure rate for weight loss surgery so I'm out to prove him wrong. I changed surgeons to Dr. Nick who told me my age and sex mean nothing and I'll do great. I'm ready for this. Denied once by Cigna, fought back and won. Surgery date: July 31st, Baylor Plano.