Anyone Have Cigna?

[brandincole31 0]

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

[TiredOfChubRub 21]

I am so nervous that my clearance for surgery is going to take forever with Cigna, and I have a really hard class that starts right around the time that I should be having my surgery! Ugh. I am in month 6 of my weight loss program. I wonder if I should call the insurance person in my surgical office and ask her to call them? I have been through all of my appointments. UGH!!! What should I do?

[MrzSongbird 53]

You are done lady bug Cigna only requires three months. Contact Cigna and your surgeons office asap! Good luck

[TiredOfChubRub 21]

Thank you MrzSongbird! I need to call them in the morning. I don't want to get my hopes up!!!

[MrzSongbird 53]

Oh wait....have you done your psych eval. and your nutrition assessment? Those were required for me .

[TiredOfChubRub 21]

Yep, 2 nutrition apts, psych eval, exercise physiologist eval, and weekly weight loss apts since the beginning of feb.

[MrzSongbird 53]

Ooh I'm so excited for you! I have one more weigh in, psych eval, and nut assessment. Keep me posted

[Ready4success 380]

I have Cigna OAP, and I have my PCP visit Wednesday morning for clearance, and my last NUT visit on Thursday morning. I'm really hoping for a mid August date. Fingers and toes are crossed that I get approval on the first go round.

[Radwilk 4]

I have CIGNA OAP as well. I was wondering if CIGNA considers GERD a comorbidity? This is the only comorbidity that I have current documentation of having an offical dx. My BMI is 35-36. I have completed 5 months of the formerly required 6 months nutritionist supervised diet (its now 3 months). I have completed the psychiatric evaluation. I have had a few visits with my surgeon including the initial consult and a couple of follow ups. Now I am just prepping myself to visit with my PCP, which I am nervous about. I don't know if I have other comorbidities. Of course my knees, hips and back all hurt. My left foot has had 2 stress fractures. My blood pressure has increased by about 20-30 pts, but it was actually VERY low when I wasn't this overweight years and years ago. The top pressure was under 100 most of the time. So I don't see that I have HBP exactly. I haven't been tested for sleep apnea, pulmonary hypertension, hyperlipidemia (sp?) etc. I guess I just don't know where to start with the comorbs. I feel terrible all the time so something isn't right. I have avoided doctors for a while because I know they would tell me to "just lost weight and you will feel better" and I couldn't keep the weight that I lost off. UGH. Sorry to unload, but I am so nervous that I will be denied.

[Pinky Green 260]

I was originally told that with Cigna I would have to do 6month supervised diet but when I went in yesterday I was able to confirm that it had been changed to 3 months so it looks like my surgery will jump from December to September or October. This is really good news.

[MrzSongbird 53]

I have CIGNA OAP as well. I was wondering if CIGNA considers GERD a comorbidity? This is the only comorbidity that I have current documentation of having an offical dx. My BMI is 35-36. I have completed 5 months of the formerly required 6 months nutritionist supervised diet (its now 3 months). I have completed the psychiatric evaluation. I have had a few visits with my surgeon including the initial consult and a couple of follow ups. Now I am just prepping myself to visit with my PCP' date=' which I am nervous about. I don't know if I have other comorbidities. Of course my knees, hips and back all hurt. My left foot has had 2 stress fractures. My blood pressure has increased by about 20-30 pts, but it was actually VERY low when I wasn't this overweight years and years ago. The top pressure was under 100 most of the time. So I don't see that I have HBP exactly. I haven't been tested for sleep apnea, pulmonary hypertension, hyperlipidemia (sp?) etc. I guess I just don't know where to start with the comorbs. I feel terrible all the time so something isn't right. I have avoided doctors for a while because I know they would tell me to "just lost weight and you will feel better" and I couldn't keep the weight that I lost off. UGH. Sorry to unload, but I am so nervous that I will be denied.[/quote']

I don't see why you'd be denied, sounds like you fit the criteria to me. Include as much info as you can to state your case. All the best to you and keep us posted.

[NHJulie 13]

I was originally told that with Cigna I would have to do 6month supervised diet but when I went in yesterday I was able to confirm that it had been changed to 3 months so it looks like my surgery will jump from December to September or October. This is really good news.

That is fantastic! Good luck!!

[TiredOfChubRub 21]

My program doesn't want to "risk" taking the chance that it's wrong info which frustrates the crap out of me. But I am only 2 1/2 weeks out from 3 months anyway so it's not a big deal.

[Pinky Green 260]

My program doesn't want to "risk" taking the chance that it's wrong info which frustrates the crap out of me. But I am only 2 1/2 weeks out from 3 months anyway so it's not a big deal.

Couldn't they just call Cigna?

[TiredOfChubRub 21]

I would think so and I would be aggressive about it but they are really working with me about getting me in for surgery before my fall class starts that I am taking so I don't want to Rick the boat over a few weeks.