Just Got Approved Through Cigna Oap!

[Ready4success 380]

My paperwork was sent by my surgeon last Tuesday, and was accepted by Cigna on Thursday. I called on Friday just to make sure, and was told a decision would be made no later than today...and yep, I got the call saying I was approved. Not sure how I feel, overwhelmed that this for real now. The surgery scheduler is supposed to call with a surgery date. Good Luck to everyone with Cigna, sometimes they can surprise you.

[IMSKINNY 160]

Congratulations! We're on our way...

[scorpio2479 237]

Congrats. I'm w/ Cigna as well & all my paperwork was sent over yesterday.

[scorpio2479 237]

?...during the 3 mth nutrition classes did anyone loss or gain? I did gain like 2lbs & now I'm worried. My BMI is 42.

[UTGal99 327]

I am with Cigna too and am hoping to get approved soon too.

The requirements for them are only as follows, right?

1) 3 months of doctor visits

2) Bariatric surgeon clearance

3) PCP clearance and letter of medical necessity

4) Meet once with a nutrionist

5) Clearance from a pyschiatrist

6) Meet BMI requirement

Anything else I should be aware of?

[scorpio2479 237]

Yes UTGAL99 that's all I had to do.

[UTGal99 327]

One last question:

What happens if your weight goes up by a 1-2 lbs during your 3 months of documentation?

Also, I meet with my PCP in May, June and July. Does that count as 3? Or does May count as the baseline and you need June, July and August? Do you know???

[joyful noise 101]

I had to do the nutritionist thing every month for 6 months, they have now dropped it to 3 months; had the psych evaluation; got a letter of necessity from my PCP; got a call last week that they wanted my PCP letter amended and said something about the 6 months of nutrition meetings and it was all messed up.

I had made an appt for Dec. 23, when I got there they didn't make it with the nutritionist...so, I had to re-schedule for Jan 9 and had been going every month right through June. I don't drive so hubby took the Dec. day off for nothing.

I really hope nothing is now messed up; haven't heard it it was submitted yet or anything else I will have to do - chest x-ray, etc.

The waiting and not knowing is the angst.

[UTGal99 327]

I had to do the nutritionist thing every month for 6 months, they have now dropped it to 3 months

Meet with a nutrionist for 6 months? Or meet with your PCP? I read the Cigna guidelines as meeting with your PCP for the 3 months consecutively not a nutrionist. I see the only requirement for a nutrionist is medical clearance and one meeting by a dietician/nutrionist.

[Ready4success 380]

Thanks everybody!!!!

Here is what I did:

1. April 27-Initial surgical consult (visit #1)

2. May 24-Met with dietician (visit #2)

-Lab work & EGD done

-Psych eval done

3. June 27-PCP (medical necessity/clearance)

-Met with dietician (visit #3)

-Final Nutrition consultation

5. July 24- Got approval

You only need 3 visits, and the first visit counts.

I tried to streamline the process as much as possible by using the surgeon's dietician on staff just to save time with fewer delays. I did use the psych through my insurance, since their psych was cash only. I paid my $25 co-pay instead of their $215 cash fee.

I lost 8 pounds and gained back 3, so I don't think it matters. I expect to lose at least 10 pounds on the pre-op diet.

It was very frustrating at times, but it was worth it. My surgery, hospital stay, and all associated fees are covered at 100%. Woohoo!!!!

[joyful noise 101]

I had the option to meet with the nut or my pcp. I chose the nut.I learned alot at the nut meetings that I would not have otherwise known if I met with my PCP.

[Mensch 150]

Congrats!!