insurance Cigna gone crazy?

[PGee 318]

Just a quick follow up, my Dr's sent over paperwork on 7/2.....on 7/10 I called Cigna, and they said they just received it that day. When I emailed my dr's office, this is what they said: "When we open a request for authorization they send us a fax with a barcode and a fax number which directs it straight to a nurse case manager that reviews our request. So maybe it was sent to the nurse and scanned under your record for review yesterday"

The good news.......for now.......The person at Cigna told me they would have a reply within 5 days.......I'm assuming that doesn't include weekends.......

good luck to everyone.

[qnz234 101]

im waiting on cigna as well. im just nervous because i barely lost any weight. my weight was up and down, up and down, and the last month i actually gained. my surgeon didnt seem too worried tho. dont kno if that is just his personality. *shrug* praying...

[kmed21 41]

I called yesterday and its still in nurse review. She told me to call back Monday. We shall see.

[PGee 318]

So, I don't know if this is good, bad, or normal......today I got a letter from Cigna (well it's a copy of a letter they sent to my doctor)......wanting more information.....and all of what they are asking should have been with the doctor's office (sounds familiar, huh?).....did anyone else get this?

One odd thing is they want to know the admit date, surgery date......and I don't have that yet.....that was dependent upon being approved (or so I thought).......of course it's a weekend, and I can't get in touch with the doctor's office.....so I definitely won't have my answer by Wednesday.....darn! (go ahead and substitute that for a stronger word, I did LOL) Oh well, wish me luck.......and a lot of patience......thanks!

[CCRNonherway 78]

So' date=' I don't know if this is good, bad, or normal......today I got a letter from Cigna (well it's a copy of a letter they sent to my doctor)......wanting more information.....and all of what they are asking should have been with the doctor's office (sounds familiar, huh?).....did anyone else get this?

One odd thing is they want to know the admit date, surgery date......and I don't have that yet.....that was dependent upon being approved (or so I thought).......of course it's a weekend, and I can't get in touch with the doctor's office.....so I definitely won't have my answer by Wednesday.....darn! (go ahead and substitute that for a stronger word, I did LOL) Oh well, wish me luck.......and a lot of patience......thanks![/quote']

Yes I got that too. Cigna has a two step process. The doctor "opens" the claim, which generates this letter but more importantly it gets your claim assigned. Then the doctor submits your packet. Ps, don't worry about the date, when its approved your doc will adjust the date with Cigna. Good luck!

[PGee 318]

Yes I got that too. Cigna has a two step process. The doctor "opens" the claim, which generates this letter but more importantly it gets your claim assigned. Then the doctor submits your packet. Ps, don't worry about the date, when its approved your doc will adjust the date with Cigna. Good luck!

Oh thank goodness! Many thanks!

[can't weight 8]

I called Cigna again as I have the paperwork from my PCP's office and was told my surgeon has to submit the additional paperwork. I'm frustrated in that if they had done that in the first place, we wouldn't be in this mess.

[Andrew0929 1,101]

One of there restrictions added in may was 3 months = 90 days' date=' or something similar. once you've got all of their requirements filled, they'll approve you.

[/quote']

Thanks for posting these rule changes. My surgeons office didn't point this out. Given my prior dealings with CIGNA I expected something like to this to surface at the last minute.

I've only completed my first NUT appointment but ill be sure to space out my other appointments.

[nj8988 18]

My first step was to know this document forwards and backwards.

Cigna Bariatric Surgery requirements

mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

[evansmini 8]

Finally received my approval from Cigna today. Can't believe it's real.

[kmed21 41]

Yay!!! Congrats!!

[can't weight 8]

Congrats to you. My surgeons office is having a peer to peer review with Cigna today so they will know today if I'm approved or not.

[qnz234 101]

I've been approved! YOWSA!

[evansmini 8]

I've been approved! YOWSA!

Congrats! We even have the same surgery date

[Andrew0929 1,101]

Cigna is being very strict now on the dietician visits' date=' well about everything really. You have to do a full 90days, and all the visits have to be spaced out evenly apart. Apparently, they went from a 3 consecutive month visit to a full 90 days on May 15th. My surgery had to be postponed so i could get my 4th dietician visit in, which was today. Insurance will be resubmitted today for my July 22nd surgery. Fingers crossed. I was originally denied because I was missing my 4th visit and because of some verbiage on my PCP letter.[/quote']

I spoke to my NUT about this new 90 day rule for CIGNA and she seemed sure it was still just 3 visits. I read the rules on the Cigna website and it clearly states 3 consecutive months (90 days) of managed diet, which equates to 4 visits to me. She wanted to call my surgeons office but they are the ones that wrote 3 visits on my requisition form. I am going to call Cigna for clarification but I already know what they're going to say.