Question About Approval With Cigna Ppo?

[sabrina4you 17]

I posted this on another website but no one answered me :confused5:

Anyone approved on the first time for a revision from Realize band (2/11/10) to Sleeve?

I just recently had to change insurance from Anthem to Cigna PPO.I tried to get the revision with Anthem in Sept. and Oct. of 2011 but I was denied twice, even though I had pouch dilatation, a minor slip and very minimal weight loss (40 lbs), I was told I was denied because I haven't had my band for 2 years. It will be 2 years next month. The patient coordinator was fighting for me but I didn't get approved. In my mind I kind of gave up. I was unfilled from Sept to Dec. and I have gained closed to 20 pounds...that is half of what I lost with the band in almost two years!!! Frustation!!!!

Well, January comes and my husband's company (they always buy the weight loss rider) changes insurance to CIgna PPO. I find out that my original bariatric doctor is not covered at all. So I am referred by Cigna to my new doctor. I'm in the process of jumping though their hoops just to be seen by him, which is fine with me. I've done my research and he has a pretty good track record. The staff in the office is nice and actually listened to what I had to say, which was very important to me because I was very scared about having to start all over. I have an endoscopy scheduled for next Thursday, so hopefully after that I can get the ball rolling....

So what do you think my chances that I can get approved on the first try?

Thank You :aureola:

Sabrina

[CIGNAQuestions 0]

Hi Sabrina,

I could assist you with your questions if you'd like! All you need to do is email me your contact info to SCR_isolve@cigna.com and I would be more than happy to help you.

Ann

[sabrina4you 17]

Anybody else have any thoughts or insight?

[Mrs.Riene 16]

Well Evilqween,

I too am waiting on approval from Cigna PPO. My paperwork was submitted by my Doctor's insurance coordinator on January 2 of this year. Call my insurance coordinator at the doctor office yesterday to find out the status. She said they have not heard back from Cigna. I then called Cigna to see if I could find out the status of my paperwork. I was told the nurse has up to 30 days to process paperwork for this kind of procedure. So I should not expect to hear back from them until February 2. All I could say was, REALLY you guys are going to take the maximum amount of time to process something that could be done in just a few minutes. Her answer was "Yes". All I can say about Cigna PPO insurance is "Really"!!!

Once I am approve. I will let you know so we can see how long they actually took.

[sabrina4you 17]

Well Evilqween,

I too am waiting on approval from Cigna PPO. My paperwork was submitted by my Doctor's insurance coordinator on January 2 of this year. Call my insurance coordinator at the doctor office yesterday to find out the status. She said they have not heard back from Cigna. I then called Cigna to see if I could find out the status of my paperwork. I was told the nurse has up to 30 days to process paperwork for this kind of procedure. So I should not expect to hear back from them until February 2. All I could say was, REALLY you guys are going to take the maximum amount of time to process something that could be done in just a few minutes. Her answer was "Yes". All I can say about Cigna PPO insurance is "Really"!!!

Once I am approve. I will let you know so we can see how long they actually took.

Good Luck! I hope you hear from them soon

[Mrs.Riene 16]

I just received my approval letter from the insurance company. Have not heard anything from my surgeon's office at this time, but hope to here from them soon. The letter was actually sent out on the 24th and I received it in the mail this morning. I am so excited and ready to move forward with the next phase.

[sabrina4you 17]

I just received my approval letter from the insurance company. Have not heard anything from my surgeon's office at this time, but hope to here from them soon. The letter was actually sent out on the 24th and I received it in the mail this morning. I am so excited and ready to move forward with the next phase.

That was Super fast! Good for you!

[slim46 25]

I posted this on another website but no one answered me <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/colorful/confused5.gif' class='bbc_emoticon' alt=':confused5:' />

Anyone approved on the first time for a revision from Realize band (2/11/10) to Sleeve?

I just recently had to change insurance from Anthem to Cigna PPO.I tried to get the revision with Anthem in Sept. and Oct. of 2011 but I was denied twice' date=' even though I had pouch dilatation, a minor slip and very minimal weight loss (40 lbs), I was told I was denied because I haven't had my band for 2 years. It will be 2 years next month. The patient coordinator was fighting for me but I didn't get approved. In my mind I kind of gave up. I was unfilled from Sept to Dec. and I have gained closed to 20 pounds...that is half of what I lost with the band in almost two years!!! Frustation!!!!

Well, January comes and my husband's company (they always buy the weight loss rider) changes insurance to CIgna PPO. I find out that my original bariatric doctor is not covered at all. So I am referred by Cigna to my new doctor. I'm in the process of jumping though their hoops just to be seen by him, which is fine with me. I've done my research and he has a pretty good track record. The staff in the office is nice and actually listened to what I had to say, which was very important to me because I was very scared about having to start all over. I have an endoscopy scheduled for next Thursday, so hopefully after that I can get the ball rolling....

So what do you think my chances that I can get approved on the first try?

Thank You <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/colorful/aureola.gif' class='bbc_emoticon' alt=':aureola:' />

Sabrina[/quote']

Hello, my names Rosa and I had the Lap band as well about 2yrs ago. I ve had reflux problems, bronchitis every 3-4 months , i sleep on 3-4 pillows, snoring, HTN problems and only lost 20 lbs but gained it all back. Now after several tests ( ESD and an Upper GI) the dr says I have to have the band removed due the constrictions without any fill. Now I'm tryn to opt for the sleeve.... Im 51y, 247lbs n tryn to get the ball rolling. Hopefully, I won't have problems with the insurance

[MrzSongbird 53]

Can anyone help me with how I must pay my deductible an so forth. I have Cigna as well. Cigna said I will have a hospital copay of $250 a deductible of $200 and my Out of pocket is $1500. Do all these monies have to be paid in full before surgery can take place?

[innerme 26]

Can anyone help me with how I must pay my deductible an so forth. I have Cigna as well. Cigna said I will have a hospital copay of 250 a deductible of 200 and my Out of pocket is 1500. Do all these monies have to be paid in full before surgery can take place?

Typically you wd pay your copays up front. As far as the remaining estimated due to the hospital and doctor that wd be up to them if they bill or require before surgery. I have to pay my copays and the Estimated due amt to the surgeon prior to my surgery, the remaining hospital, anesthesia, etc will be billed to m after the surgery.

[CIGNAQuestions 0]

I would like to help answer your questions or concerns you may have. Please feel free to Email me @ LetUsHelpU@cigna.com. Thank you.