Help! Insurance Question.

[Daney 0]

A year ago I called my insurance company (Cigna) and asked if they covered LAPBAND surgery, the rep said it is not covered but after calling around the doctor said that they do cover it if it is medically necessary. After my initial consultant visit they sent in information to my insurance. They have covered all my appointments. A month ago my doctor called and said the surgery was approved and the next day they said they recieved a letter saying it wasnt. They fought it with my insurance and they once again approved the surgery. Since then I have done all my pre op requirements and have a set date for surgery. Yesterday my doctor called again and said they denied it again. How can they do this after approving it twice? I don't understand! Anyone have any advice or gone through the same thing? My surgery date is 4/19.

[new_journey4me 1]

I have Cigna and it is covered by insurance -90%. I had to do a 6 month nutritional program and provide weight history. That was required by Cigna. Plus I did all the other requirments as well.

I'm nervous now about getting approved - but I haven't heard Cigna denying too many people.

[Daney 0]

I have done all the requirements, and have went to my pre op appointment and surgery is scheduled for a week from today! Cigna originally approved it then denied it and then approved it again within a week. Now they are saying they arent approving it. From what the surgeon's office has said is it is because of the billing codes, because Cigna does not cover Lap Band to treat obesity which they filled it under which instead they were suppose to file it under medically necessary due to back problems. I just wish I knew what was going on, because its a week away!!

[new_journey4me 1]

Oh God - I hope that my surgeon knows to put it in as medically necessary. I should call to make sure. Now I'm even more nervous!