Cigna Approval Process

[kadive 21]

My paperwork was submitted to cigna on Monday and called today for an update and they told the medical director had the case for last review. Its that bad or god???

[Ready4success 380]

I was told the same thing and my approval letter came in the mail 3 days later.

[AliciaA122 24]

Mine is with the medical director too. I'm hopeful.

But, I'll have to have mine submitted again no matter what because my surgeon quit his group on Friday and I've had to find a new one. Lovely.

[Izuri 428]

I'm keeping my fingers crossed for you! =)

Alicia - that's so frustrating! I'm sorry to hear that =((

[Losingitforgood! 50]

I Submited on July 16. Called every day after. It was in the medical directors desk July 24 morning. Called later in the day and got my approval! The letter came 3 days later. You are very close! Good luck!

[scorpio2479 237]

Ive been calling Cigna everyday since 7/24. Todays status is the same as yesterday it's in a nurse review & either the nurse approves it or it is sent to a medical director for approval or denial. This is what a Cigna rep explained to me. I'm pretty sure I'm approved or @ least that is what I keep telling myself!!!

[AliciaA122 24]

I wonder why some go on to the medical director and others do not?

[scorpio2479 237]

I tried probing w/ the rep to better explain to me why it would need a medical directors approval. I did not get a good understanding w/ the explanation she provided.

[vdunn87 2]

My doctors office had told me it was based on patients bmi and co-morbidities. I know I've asked this many times, but how long does it actually take to get a response? I has my paperwork sent yesterday 7/30. I'm probably dreaming but I'm hoping its the 5 days I've heard about. lol

[Nikki613 120]

It took me 19 days before I received my approval....I have been told Cigna is the most difficult and lengthy to deal with but that they are trying to strealine the process. Mine waiting was horrible. Good luck everyone. My fingers are crossed far you all.

[AliciaA122 24]

I was denied. The reason being that they need/ want another doctor (in addition to my surgeon) to clear me for surgery. Seems unfair to me since that's not one of the requirements per their policy. Also seems they should request that and then deny if it's not received instead of just denying.

No matter. My new surgeon's office has to file everything all over again anyways. Guess I'll see if my PCP can write something theyll accept as the second clearance. Hopefully thus denial won't addict that next submission. The insurance rep I spoke to this evening said it wouldn't.

[Nikki613 120]

I was denied at first for the same thing, but in my case I did have the second clearance letter they just apparently lost or didnt receive it. My surgeon faxed it over and I went through a reconsideration. I was approved in about a week and a half after the second submission.

I think it is pretty standard that the insurance companies want a second clearance or recommendation from another Dr other than the surgeon. All of the different surgeons offices I researched had another Dr they worked with for this reason.

I bet you will be approved. I would try and find out exactly the wording they will need. Cigna can be picky on wording.

[AliciaA122 24]

Thanks! Good to know.

[AliciaA122 24]

Thank you!

[scarletskinnygirlinside 8]

AliciaA, I can sympathize, I work at a hospital in which the bariatric surgeons have decided to leave our hospital so if I get approved in time, I will not have a problem. Well,except that I met with him for the first time today and he was basically saying that with my especially high bmi he would rather operate on me at the hospital that he is moving to... Really sucks!!!! Means that my insurance would not cover as much so I am going to throw a wrench in his works if I get approved in time and he does not want to do the surgery on me at my hospital, I am going to change surgeons!!! Really anxious and just ready to know already! :/