Cigna Insurance

[lucclu81 21]

Hi.... My surgery is scheduled on 7/24 and I'm waiting for approval from Cigna. I'm very nervous that I will not get the approval... How long did it take to get approval. I'm on my pre op diet right now and it would be sad to go through all this and not get to the grand finale.... Gastric sleeve

My initial decision was the band and I was approved for it within days. However, I switched to the VSG and that took a little longer....only because all the paperwork wasn't together. Plus my primary care doctor's assistant decided to play doctor and decide that my doctor would not provide the clearance letter needed for pre-approval. So it took about a month. I would encourage you to follow up did you get anything from CIGNA yet? Call CIGNA? Call the surgical coordinator etc. when was your paperwork submitted? I think once all the paperwork is in place approval doesn't take that long. Good luck!!!

[Jersrose43 837]

The rule is Cigna has 5 business days

If it needs a medical director review it could be 10.

Never heard of it taking longer unless there was a specific reason (pending document).

Yes I do work there.

[Ania40 7]

Thank you both very much for the reply. Hopefully I will hear something next week. I'll call office on Monday and ask them when did they send out the paperwork.

[mhenne97 35]

I know you are glad the process is over.... now waiting on our survey date... Congratulations!!!

My approval from Cigna was really quick. It was my doctor's office that gave the challenge. It took them submitting paperwork to Cigna 3x to get my approval.... their fax machine apparently was not submitting all of the needed pages. Two denial and ONE approval letter later, here I stand awaiting my date from the doctor's office. Hopefully I will have something tomorrow.

Edited July 13, 2014 by mhenne97

[mhenne97 35]

My approval from Cigna was really quick. It was my doctor's office that gave the challenge. It took them submitting paperwork to Cigna 3x to get my approval.... their fax machine apparently was not submitting all of the needed pages. Two denial and ONE approval letter later, here I stand awaiting my date from the doctor's office. Hopefully I will have something tomorrow.

Yes, I am. I almost didn't know what to say when they finally said APPROVED!

[jmart65620 4]

I know you are glad the process is over.... now waiting on our survey date... Congratulations!!!

My approval from Cigna was really quick. It was my doctor's office that gave the challenge. It took them submitting paperwork to Cigna 3x to get my approval.... their fax machine apparently was not submitting all of the needed pages. Two denial and ONE approval letter later, here I stand awaiting my date from the doctor's office. Hopefully I will have something tomorrow.

hi girl I also have Cigna. I am doing my supervised visits, on august 4 th I will have my 4th visit (only needed three) however, they do not equal to 89 days or more? Did you do the supervised NUT?

[mhenne97 35]

hi girl I also have Cigna. I am doing my supervised visits, on august 4 th I will have my 4th visit (only needed three) however, they do not equal to 89 days or more? Did you do the supervised NUT?

Yep, I did. Same thing with the 4 visits so it would be 89+ days. Is this your last step before going to insurance? Make sure you get a letter of recommendation from your PCP. I didn't have that and that slowed me up a few days.

[Ania40 7]

Hi, I just find out my PCP doctor is on vacation and I can't get recommendation letter till next Monday and my surgery is next Thursday 7/24. I think I'm bummed . I will never get approval from insurance in 2 days

[Dallas_P 34]

I am amazed that so many people are able to get a surgery date before they have insurance approval. For those that are self pay I understand but my Doctor won't even discuss surgery dates until there is a written confirmation from the Insurance Company.

For me the whole approval process was a complete nightmare. It took a total of 75 days before I finally got approval.

In the first go around I had to wait until the afternoon of the 30th day before Cigna would even tell me that I was denied. I had called Cigna weekly to see if they had everything they needed to make a determination and they told me that they did. When I was told that my surgery was denied they said it was because my application did not contain my Physicians letter reccommending surgery and clearing me for surgery. I went to great lenghts to get the letter so I know it was sent. I was also told that my file did not contain clearance from a mental health professional and yet that was in my file as well.

I protested and we resubmitted everything and did get approval 15 days later. Only problem was by that time I had my endoscopy which showed that I had 10 polyps in the stomach. I had originally applied for the gastric bypass RNY surgery but the problem with that surgery is they completely seal of your old stomach and make a small pouch which becomes the new stomach. My doctor and I thought it would be advisable at that time to do the sleeve instead because with the sleeve the polyps could be monitored and a new endoscopy done every three years.

So we had to apply again and wait another 30 days. I had mentioned before that Cigna said that they only give quick 5 day approvals for those patients that are requesting overnight stays in the hospital. My doctor and hospital require that the surgery be listed as outpatient with 23 hours of observation (which means one overnight stay possible).

To top all that off before I could even apply to Cigna I had to get clearance from my cardiologist because I had an abnornal EKG. I had to do a nuclear stress test which was inconclusive and eventually had to have a heart cathertization done (which cost more than the sleeve surgery). In the end all is good but you can see why it might be dangerous to schedule your surgery before the approval process with all the possibilities of things that can go wrong.

The good news is, is that on this Thursday I am going through the pre-admission testing at Baylor Regional Hospital in Plano, TX and if all goes well I'll have surgery on Thursday July 31st.

Best of luck to all the July Sleevers that have had this done and to all those that will have it done. The process can be confusing and frustrating but well worth it in the end. I propose that someone should start a threat next year of all the July 2014 sleever and have everyone post before and after pictures. No one will remember then the insurance company frustrations and we'll all be able to Celebrate the great accomplishment we all have made in our appearance but most importantly ourt health.

Good luck everyone!.

[mhenne97 35]

Hi, I just find out my PCP doctor is on vacation and I can't get recommendation letter till next Monday and my surgery is next Thursday 7/24. I think I'm bummed . I will never get approval from insurance in 2 days

Go to your nearest urgent care. They can take care of you. That's what I did. Worked for me!

[Ania40 7]

Thanks I'll try that

[lucclu81 21]

If the staff and surgeon are well versed in the approval process you can be approved in days....granted if all your paperwork is in line. In my case I got my date late June n my surgery was scheduled for 07/24. If my paperwork was complete I would have been approved in 5 days.

[Jersrose43 837]

Go to your nearest urgent care. They can take care of you. That's what I did. Worked for me!

They wrote a letter recommending the surgery for you? Find that hard to believe and even harder to believe insurance accepted it.

[Jersrose43 837]

Hi, I just find out my PCP doctor is on vacation and I can't get recommendation letter till next Monday and my surgery is next Thursday 7/24. I think I'm bummed . I will never get approval from insurance in 2 days

Can you have the office staff write it and just wait for doc to get a signature?

Or call you ob gyn and have them write it if possible.

[Ania40 7]

Oh my god, you're the best..... I will call my Ob Gyn today and ask if he can do it. He's my doctor also. Why I didn't think of it.

Thanks a lot. I'll let you know if he did it.