Theex01

So my Surgeon's office submitted all "complete" documentation for VSG, only to get it kicked back from Cigna stating they need CPT codes, a surgeons letter and also a formal nutritional evaluation. So surgical coordinator submitted a "reconsideration" with all additional info. Then it got kicked back again because they wanted an in depth nutritional evaluation from an registered dietition. I completed that last week and surgeons office re-submitted. Now Cigna is saying they will not accept any more reconsiderations (I guess 1 is the limit) and now there is a peer to peer review scheduled for tomorrow afternoon. My surgery is scheduled for 6 days away!! It's been pushed back a week already. I'm nearly sick from the stress. Apparently my surgeons office never has this problem with Cigna and we have submitted absolutely everything insurance requires. Has anyone gone through the peer to peer review process and been approved? I'm so nervous!

@@Beautifulblue Thank you and good luck to you too!!

Thank you both for the information, it has eased my nerves a bit! I'll give an update when I hear back on my answer tomorrow

@@Beautifulblue I have Cigna and their response time is quick. Within a couple days. I've also been denied twice and now I'm waiting on a peer to peer review between my surgeon and Cigna, which will take place tomorrow afternoon and then I'll know if I'm approved. Fingers crossed for both of us!!

@@theotherfatgirl I am SO STRESSED OUT right now. I was denied initially because Cigna said they needed CPT codes in writing from surgeon, as well as letter from surgeon recommending surgery and also the nutritionist evaluation. So my surgery scheduler submitted all of those items on the 26th. I called today and they said its denied again but then I spoke with surgery scheduler and she says its still pending and she will follow up again Monday and let me know. I'm so stressed out I'm nearly sick, surgery is supposed to be in 13 days and Cigna keeps shuffling around with surgeon...please keep a prayer or good thoughts my way! Did you hear on yours?

@@theotherfatgirl I haven't been told officially when to start the pre-op diet but I think it's only a few days before surgery. They go over it in the pre-op orientation the week before surgery. From what I've researched, it seems that Nevada is less strict with requirements. When do you start yours? Have you decided on what kind of Protein shake or powder to buy? I've been checking that out today online. Unjury seems good but I know Premier Protein is really popular. I was hoping for surgery earlier cause I booked a Hawaii vacation for August 7-19, thinking I'd be all thin by then. So I'll have 2 months to get as much weight off as possible! LOL It's great that we have goal dates though, to work towards. @@Martene81 Congratulations!!! That must be such a relief for you. I can't wait to get that call so I can chill the heck out already LOL

@@theotherfatgirl Wow, you must have good insurance! I can't believe that's all you needed. Awesome. I consider myself lucky cause my insurance only requires 3 months of weigh-ins and a lot of others have to weigh-in for 6 months prior to approval. I made it my New Year resolution to get this surgery and I had my first Dr. Appt. on 1/24/15 and now, 6 months later, I finally get surgery. Patience has definitely been key in this process! Looking forward to seeing our progress : )

@@Cat50 My insurance (Cigna) required PCP documentation for 3 consecutive months of weight, diet and exercise program. They don't require weight loss, just documentation of program and weight. Then I had to get chest x-ray, cardiac clearance letter from cardiologist, a Psychiatric evaluation, and blood testing.

@@theotherfatgirl I am in the same exact boat right now! My surgeon booked my surgery for June 10 and I'm waiting to hear if Cigna approves me. I keep waiting for the call from my surgery scheduler. My patient advocate said my paperwork looks perfect (I did have to get a few additional documents before she would submit) so fingers crossed for both of us! Eek so nervous!!