Band to Sleeve with Cigna

[Jersrose43 837]

Did Cigna send you a rejection letter? It is a requirement. On that Letter they tell you exactly the rejection - billet points and on the 2nd page is appeal process.

You need to write a letter

When you had first surgery

Why it failed - include medical records of possible

Who is recommending the new surgery - include letter from those doc's

Then address each of their rejection bullets with factual medical records

Your surgeon should have requested a peer to peer review after the first rejection. That is when a medical profession at the office - not a surgical coordinator- talks to the medical director at Cigna and the discuss the medical facts

That usually gets an approval

[dustinwhall 8]

I have Cigna insurance and I submitted for a revision and within 2 weeks I was approved with a surgery date of December 5th. My surgeon told me I would have no problems with approval because she has documentation for several months of follow up with her that the band was causing me problems and gaining weight. This process was so quick for me it has been overwhelming. My surgeon really went the extra step to get me approved (I'm sure she likes the money she get paid so that's why she did it not because I'm special by any means) but I would really evaluate your surgeon to make sure he or she is doing all they can for you. And good luck. I hope it works out for you.

[LSF 264]

I've completed the 90 day requirement!! Keeping my fingers crossed. My paperwork will be eligible to be sent in 1/6. Did the 3 monthly nutritionist meetings, got the psyc evaluation and surgeon & PCP approval. Also attended 2 support group meetings!! Now the wait begins.....

[LSF 264]

Now I'm worried!!! The surgeon sent in my paperwork to Cigna and they sent a letter that they want more info - AND - they mentioned about me qualifying for an outpatient procedure. There is no way I can be "outpatient" - with the original surgery I had to stay overnight because I was too sick to go home the same day -

With revision - the surgeon said to expect 2 days.

I'm hoping that I don't have to go through the appeal process. I've done everything they required!! So upset

[peacheeie 14]

Hang in there. I have CIGNA and I was approved with a BMI of 35 and 1 cormobilities. You can do it

[LSF 264]

I got approved!! My date is 2/4. Now the wait begins!!