can't weight 8 Posted July 10, 2013 My coverage with Cigna indicates that I only need to do the weight loss management program with my PCP for a minimum of 3 months. My surgeon's office submitted my paperwork to Cigna last month and they denied me on the fact that I supposedly only did 2 months of doctor supervised weight management. Here is the kicker... I actually did 5 months as I thought it required 6 months instead of the three. I am so frustrated right now about this because it's just stupid! My surgeon's office thinks we have a new person in Cigna and that they are counting the first visit as the "initial visit" which then means you have to go 4 months instead of 3. Of course in my situation that shouldn't matter as I went 5. What really frustrates me is the only good time I have to do the surgery is in August, otherwise other people are going to have to adjust their schedules for me to miss work. Hoping that this gets resolved quickly so we can still be on schedule. All I can say is GRRRRR Share this post Link to post Share on other sites
MemphisChik 27 Posted July 10, 2013 Mine's the same. I sent in a weight for March, April, and May. I'm guessing the Mar-Apr was month 1 and Apr-May was month 2 because they made me weigh again in June. I'm GRRrrr'ing right there with you, I'm trying to squeeze in for August, too. Will keep my fingers crossed for ya! What also stinks is that they were a lot quicker to deny my original claim than they're taking now. I'm frustrated! Share this post Link to post Share on other sites
MemphisChik 27 Posted July 10, 2013 Well crap. I tried to delete a post when I found I could edit my original post. Share this post Link to post Share on other sites
karpouzian 94 Posted July 10, 2013 One of there restrictions added in may was 3 months = 90 days, or something similar. once you've got all of their requirements filled, they'll approve you. My coverage with Cigna indicates that I only need to do the weight loss management program with my PCP for a minimum of 3 months. My surgeon's office submitted my paperwork to Cigna last month and they denied me on the fact that I supposedly only did 2 months of doctor supervised weight management. Here is the kicker... I actually did 5 months as I thought it required 6 months instead of the three. I am so frustrated right now about this because it's just stupid! My surgeon's office thinks we have a new person in Cigna and that they are counting the first visit as the "initial visit" which then means you have to go 4 months instead of 3. Of course in my situation that shouldn't matter as I went 5. What really frustrates me is the only good time I have to do the surgery is in August' date=' otherwise other people are going to have to adjust their schedules for me to miss work. Hoping that this gets resolved quickly so we can still be on schedule. All I can say is GRRRRR[/quote'] 2 MemphisChik and Andrew0929 reacted to this Share this post Link to post Share on other sites
can't weight 8 Posted July 10, 2013 I wonder if my surgeons office didn't submit the whole 5 months like I think they should have. It wouldn't surprise me if they had only submitted the minimum instead of what I actually did. Share this post Link to post Share on other sites
evansmini 8 Posted July 10, 2013 Cigna is being very strict now on the dietician visits, 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. 1 MemphisChik reacted to this Share this post Link to post Share on other sites
MemphisChik 27 Posted July 10, 2013 Good luck! I was sure I'd hear something Monday or Tuesday. Now I'm bordering on severe impatience Share this post Link to post Share on other sites
PGee 318 Posted July 10, 2013 How many business days did it take for cigna to reply after paperwork was submitted? I started this process before the 90 day rule, so a bit anxious about that issue.....and it could be an issue......anxious to get approved & sleeved.....don't want to wait another month. Good luck! Share this post Link to post Share on other sites
kari61 128 Posted July 10, 2013 It took me a year to finally get approved from CIGNA...I did everything required, except I didn't have 2 co-morbidities at the time and my BMI was .5 off from their standards..Took me a year of fighting with them to finally get approved...I feel your pain, good luck! 1 MemphisChik reacted to this Share this post Link to post Share on other sites
can't weight 8 Posted July 10, 2013 How many business days did it take for cigna to reply after paperwork was submitted? I started this process before the 90 day rule' date=' so a bit anxious about that issue.....and it could be an issue......anxious to get approved & sleeved.....don't want to wait another month. Good luck![/quote'] My paperwork was sent in the 26th of June, they supposedly wrote the denial on the 4th of July, so pretty quick. I just hope the appeal is as quick. Share this post Link to post Share on other sites
MemphisChik 27 Posted July 10, 2013 My original ppwk was submitted June 14th. Got denial on June 26th due to "only 2 months weight loss attempt". Submitted new claim with 2 more weights on June 28th and still waiting for response. I've never been very good with patience. I just did the math and realize my wait has only been 11 days now, when it was 12 days on the first claim. I'd have sworn I've been waiting longer. smh... Share this post Link to post Share on other sites
Chele H 427 Posted July 10, 2013 I had trouble with Aetna too. They missed an entire visit. I went Feb, March, April and May for my required 3 months of care then submitted all the paperwork. They totally overlooked the April visit and said I hadn't completed the 90 days. A phone call and fax from my insurance coordinator straightened them out. Took four long weeks to get approved. Good luck Share this post Link to post Share on other sites
kmed21 41 Posted July 12, 2013 I'm waiting on Cigna today.. Today is the 5th business day, so I'm going to call at lunch. I promised myself I wouldn't call again yesterday, and I didn't.. hahahah.. My patience worked.. But today I'm for sure calling, because it's been in "nurse review" since Monday now.. So, we shall see... kmfx! Good luck to the rest of you! Share this post Link to post Share on other sites
evansmini 8 Posted July 12, 2013 Good Luck to you, I'm very anxious to hear if you've gotten approval. My fate is in Cigna's hands as well, so it would feel great to know that they've approved someone Share this post Link to post Share on other sites
can't weight 8 Posted July 12, 2013 I called them again today and they told me they have to get the additional paperwork from my surgeons office. So now it's waiting on them. Share this post Link to post Share on other sites