My Experiance With Cigna

[IwantTHATshu 5]

at first I had no issues with Cigna! Everything was going to smoothly and I really didn't think I was going to have any issues. I finished all my pre op visits, nutrition, I had a letter of referral from my primary doctor and a letter necessity from my surgeon, 6 months nutrition, and the only thing else I needed was a psychological evaluation, which I had done early in the game. I had my meeting with my surgeon on June 18^th and they submitted everything to insurance June 20^th or 21^st. My surgery was scheduled for July 10^th, but it wasn’t until July 6^th did I hear anything for Cigna or my Doctors office in regards to approval. We received a letter saying that I still wasn’t approved! So after hours of the phone with no one being able to figure out why I wasn’t approved yet, we finally got a hold of someone named Brad who told us he got everything figured out and they were looking it over as we speak! And before he hung up he gave us the OKAY YOUR APPROVED!!...

The weekend came and went and I thought everything was all set, but I then received a call from my doctor saying I STILL wasn’t approved. So I called Cigna again and said that time they told me I was DENIED To say the least I was in tears and extremely angry that I was finding this all out THE DAY BEFORE SURGERY. Apparently they changed some things and I needed not only a referral from my doctor, but also a letter of necessity, they never received something from my surgeons office, and my psychological evaluation had to be done with in 6 months before surgery, mine was 8 months…..

Thank god I was able to pull some strings and got in to see my doctor after hours and have him to a surgery clearance and a letter, I got my psychologist to do a phone session with me and update my evaluation, and I harassed my surgeons office to figure out what the heck they were doing over there and get this mess fixed because my surgery was tomorrow.

Im sure it is partially my fault for not checking closer to the date of my surgery if everything was all set, but I cant help but put some blame on Cigna and my doctors office for both sitting on the paper work and not checking in to make sure everything was set on both ends and getting in touch with me .

I did end up having my surgery on the 10^th! I got a call from my doctor’s office around 12 pm saying to head in asap I would be the last surgery of the day.

my word of advice, double, triple, and quadruple check to make sure things haven't changed on you since you started the process and that they are on their A game and are actually working to get you approved!

[Ready4success 380]

I have Cigna OAP, but I'm having the hardest time getting the bariatric's office to submit my paperwork. I guess I'll have to double and triple check with Cigna too. I'm glad you got it corrected and it didn't change your date. I would've been pissed if I had done the pre-op diet for nothing.

[littlemiss0428 30]

I have Cigna OA as well... Its been a nightmare!!! At this point Cigna has ALL the paperwork needed for approval, but due to the surgeons office faxing everything over for a second "reconsideration" before the my medical necessity/medical clearance was included, cigna now wants a peer to peer review. I should write a soap opera about all this drama..

MY ADVICE TO ANY ONE WITH CIGNA.. have a journal with dates, names, and topic of all calls.. The customer service is very nice, and most of them have tried to help, but they arent the decision makers. This whole experience is very annoying, and confusing...

[AliciaA122 24]

Oh yikes! I have Cigna. This is scaring me. Had my last of my 6 month doctor's visit's today and have done the nutritionist and psych evals. Hopefully my surgeon's office will be able to submit everything this week or next.

I'll stay on them and Cigna!

[littlemiss0428 30]

@AliciaA122~ didnt want to scare you (lol). I was anticipating an easy approval. Ive read lots of members on VSGT getting approved in 2 days with Cigna, but this wasnt the case with me. I dont think my surgeons office was aware of the medical neccessity/clearance requirement, and I didnt fully understand it either... Just one of those things.. Im sending wonderful prayers that your approval will be in a short length of time

[IwantTHATshu 5]

@AliciaA122~ didnt want to scare you (lol). I was anticipating an easy approval. Ive read lots of members on VSGT getting approved in 2 days with Cigna, but this wasnt the case with me. I dont think my surgeons office was aware of the medical neccessity/clearance requirement, and I didnt fully understand it either... Just one of those things.. Im sending wonderful prayers that your approval will be in a short length of time

thats exactly one of the things that was missing and i had had to scramble to get to my Doctor and have him check me out and give me clearance.

I also was told that I needed to do a pier to pier, but my doctors office kept telling me it had to be with someone at cigna and with my doctor...which cigna said wasn't necessary. Once i finally got my doctors office to just humor me and try it, turns out cigna was right and they just needed someone like a nurse or medical advisor to talk to them. It really it a big mess at times.

As long as you are checking in with both ends, making sure YOUR policy is being met correctly, and are keeping track of everything they tell you, all the number they give you, and ALWAYS ask for names you should be okay. Heck, even after my whole fiasco I was able to get approved in 24hrs once they gathered all my missing things and past files and re-submitted them again.

[IwantTHATshu 5]

sorry peer to peer*, haha.

[Nikki613 120]

My expirience with Cigna was horrible, but I did get approved after being denied at first. Total process too 19 days.

I called a couple days after and was informed that they had received my paperwork, should know in 5 days.

Called on day 5, they dont have my paperwork? When I informed them a few days prior they did have it they put me on hold forever.they found it in the wrong department and so they faxed to the correct department. They said 2-3days i should know unless they required more information.

Called again 2 days later. Again, they couldnt find it in the system so I explained the previous situations. After they called the precertification department, they said it was opened that day and they had everything they needed. They said it would be about 5 days. lol ok.

The next morning my insurance coordinator called from my surgeons office to explain that I may get a rejection letter but ignore it. when sbe called to check on the paperwork that morning they needed something she had already faxed so she faxed again. She said she believed I would be approved this week.

Following week they still hadnt reviewed my case. They kept saying 24-48 hours. I called every few days. No news

Then one day I called and they said APPROVED! I was so happy! I called surgeons office. The coordinator called and said Cigna said it was not approved and still pending. So I called again and was told I was approved but they wouldnt email or fax me my approval. So my insurance coordinator called again and they still said pending.

UGH I almost pulled my hair out!

About 2 days later my Surgeons office called and they had my approval letter in hand! THANK GOD!

So my advice is also to keep on top of them!!! Be pleasant and nice but keep calling.

[Nikki613 120]

Also my surgeons office said Cigna is by far the most difficult to deal with. She said they like to take thier full 30 days. On the other hand I have heard people say they are trying to streamline the process. BEST OF LUCK to anyone still waiting..

[JennyB 25]

This all stinks, I was prepared for a long fight, but it took less than a week for my approval. Sending out some good vibes for you guys!

[JazzyJ 34]

I was denied-again. We sent in the medical clearance, but they said it did not provide "unqualified clearance" for the surgery. I don't have the letter so I don't know exactly what it said, but one would think the doctor would know how to write the medical clearance letter to get it approved. We now have to do the peer to peer review. My paperwork was originally submitted in May...very frustrated with Cigna, with my doctor's office and the entire process.

[JazzyJ 34]

I got a call from my doctor's office-they received the approval from Cigna!! But-now I have an endoscopy scheduled next week, the surgeon can't get me in for an appointment after that until Sept. 5th, and then maybe I can get a surgery date. Right now, he is booking in mid October...

[AliciaA122 24]

Still, you're approved! So that's a major relief at least!

[AliciaA122 24]

I talked to my surgeon's office today and was told they received the notes/referral from my PCP this morning. After doing a cursory glance she said it looked like they had everything they needed. My surgeon just needs to review my PCP's reports and then everything will be submitted to Cigna. Ugh. I'm so nervous. I hate waiting.

[klerose 14]

oh no yall I have a doc appt next Wednesday and I've been so excited but I have cigna and now I'm freaking out!!!