CIGNA people-How long did it take for approval/denial?

[michiganer 0]

God will deliver those who trust and believe in Him. Don't give up!

Thank you so much for your encouragement! I truly feel as if God has led me to the lab band. I heard about the band years ago but always thought I could lose weight myself. I just turned 26 years old three days ago so I figured I had youth on my side. I am 5'4 and I now weigh 335lbs. I am insulin resistant, have polycystic ovaries and have hypothyroidism. My body aches and I am getting to the point where even wiping myself is diffucult. I realized that I cannot continue to kid myself. I need help now. The problem before was that I had no insurance. I knew I wanted the surgery but as a college student living on my own, could no afford.

I have worked at the same company for 8 years. Always part-time. Last year, a full time position opened up with benefits. I applied and got the job. I told myself before I got it that this was my chance. I prayed and prayed and honestly felt that God would give me this job to literally save my life. (funny, I always thought working more would kill me, not save me). I purpousely chose Cigna because I knew they covered lap band. In fact, I called cigna before I even knew I got the job to ask them about coverage. Then I found out about the 6-month diet program and all of the other hoops you have to jump through. I was discouraged but I knew this was all part of God's plan. Like I said before, I have two more visits with the nutritionist and I am almost there. In the meantime, I am looking for a psychologist and going to get letters of medical necessity.

The one question I have is, did you send all of the paperwork to Cigna or did your doctor do it? I am trying to get my records for the past 5 years from one of my doc's and it is proving to be difficult. Did you gather everything yourself and send it? I guess if it was easy, everyone would do it right?

Thanks again for your inspiration. I will continue to post and let people know how my journey is going. God bless! Trisha

[LapBandPsych 0]

It takes 6 months for the process not matter what you do. Allcare.net

[LapBandPsych 0]

Doctors are the worst responders. Talk to the office and get the paperwork back. Be persistent

[michiganer 0]

Doctors are the worst responders. Talk to the office and get the paperwork back. Be persistent

Well good news. My doctor called me today and they said my records are ready. These are the last 5 years with just the pages that have my weight written down. They are charging me $14 to get them which is fine by me.

[bfyneNtyme 0]

Thank you so much for your encouragement! I truly feel as if God has led me to the lab band. I heard about the band years ago but always thought I could lose weight myself. I just turned 26 years old three days ago so I figured I had youth on my side. I am 5'4 and I now weigh 335lbs. I am insulin resistant, have polycystic ovaries and have hypothyroidism. My body aches and I am getting to the point where even wiping myself is diffucult. I realized that I cannot continue to kid myself. I need help now. The problem before was that I had no insurance. I knew I wanted the surgery but as a college student living on my own, could no afford.

I have worked at the same company for 8 years. Always part-time. Last year, a full time position opened up with benefits. I applied and got the job. I told myself before I got it that this was my chance. I prayed and prayed and honestly felt that God would give me this job to literally save my life. (funny, I always thought working more would kill me, not save me). I purpousely chose Cigna because I knew they covered lap band. In fact, I called cigna before I even knew I got the job to ask them about coverage. Then I found out about the 6-month diet program and all of the other hoops you have to jump through. I was discouraged but I knew this was all part of God's plan. Like I said before, I have two more visits with the nutritionist and I am almost there. In the meantime, I am looking for a psychologist and going to get letters of medical necessity.

The one question I have is, did you send all of the paperwork to Cigna or did your doctor do it? I am trying to get my records for the past 5 years from one of my doc's and it is proving to be difficult. Did you gather everything yourself and send it? I guess if it was easy, everyone would do it right?

Thanks again for your inspiration. I will continue to post and let people know how my journey is going. God bless! Trisha

Hello..

I had my doctor send all the information at once. You really don't need 5 years of data, 6-12 months is sufficient. Because you have health conditions, this will be a driving force that Cigna will find hard to deny! If you can get a generic letter from a dr for the last 6-8 months stating that you have tried diet and exercise but little to no success would be great. Cigna is not as difficult as they try to make you think they are. But what they do attempt is to wear you down so you stop pressing towards the mark, don't allow them to do that. Have your Dr's office fax in the Psy Eval and a letter from your PCP stating the weight loss attempts and that is all that they require. Once the information is faxed over..call about 4 days later and start asking questions. If you don't get a denial letter within the first 2 weeks you are approved! Once you're approved they will make all kinds of promises of sending different paper work, etc you'll never get it. Demand the information via phone and or fax. I will say a prayer for you tonight! Keep believing and trusting in God to make a way out of no way!

Warmest Regards!

[michiganer 0]

Hello..

I had my doctor send all the information at once. You really don't need 5 years of data, 6-12 months is sufficient. Because you have health conditions, this will be a driving force that Cigna will find hard to deny! If you can get a generic letter from a dr for the last 6-8 months stating that you have tried diet and exercise but little to no success would be great. Cigna is not as difficult as they try to make you think they are. But what they do attempt is to wear you down so you stop pressing towards the mark, don't allow them to do that. Have your Dr's office fax in the Psy Eval and a letter from your PCP stating the weight loss attempts and that is all that they require. Once the information is faxed over..call about 4 days later and start asking questions. If you don't get a denial letter within the first 2 weeks you are approved! Once you're approved they will make all kinds of promises of sending different paper work, etc you'll never get it. Demand the information via phone and or fax. I will say a prayer for you tonight! Keep believing and trusting in God to make a way out of no way!

Warmest Regards!

Thanks again! I appreciate all of your advice. I just picked up 5 years of weight records so I will fax those too as an extra measure. I need to schedule a psyc eval still. So I should fax the psych eval, the letter, the 5 years of weights and the nutritionist 6-month diet program all together right? I guess I need to make the copies and give them to US Bariatrics and they can fax them with their paperwork so it is all together. I really hope and pray that Cigna goes easy on me. I have gotten this far and they will not discourage me with technicalities. I will call and call and call until I get what is needed. Thanks again! And thanks for the prayers!

[Sooverit! 1]

Dear Bfyne:

Wish I knew your real name :-). Thank you so very much for writing us such a detailed and informative letter on your experience with Cigna so far. Congratulations!! I would love to know how you are progressing post-op? How are you feeling? Hope you are as positive as ever?

I was so excited when I saw your BMI. I too have CIGNA and my BMI is 36/37 with no comorbities, only high cholesterol and a recent back problem that the Chiropractor said was due to weight gain. I know these aren't on the "list" but I am praying that they will be taken into consideration.

My PCP said he would be willing to recommend surgery only problem is the local surgeon said I wouldn't qualify! At least that's what the office staff said when I called to make an appt. (Dr. Geiss in LI, NY) ...they said my BMI was too low and that I needed a 38 BMI with high blood pressure or diabetes or 40 with no co-morbities. Typical American Doctor who only wants to treat the sick and forget preventative medicine! I know I will find a doctor who would do it but it makes me nervous that CIGNA would pay for it now. I do have 6 months doc supervised doc. under my belt. No proof of weight watchers but have been on every diet know to man with no major weight loss except for Atkins and that was 13 lbs. ...amazing you lost 88!! I have been overweight for the past 10 years since my last pregnancy. I am miserable at this size please send a prayer. thanks for everything.

[Sooverit! 1]

Dear Mich: Just checking in...it's been almost a month since you wrote in and was wondering if you have a sugery date yet or have you already had the procedure? I'm thinking positive!

All the best,

Marg

[michiganer 0]

Hi Marg. My name is Trisha. I have not gotten a date yet. I have one more nutritionist appt next Monday and I go for my Psych eval tomorrow. My PCP and my endocronologist are supposed to be sending me letters of medical necessity but neith has arrived yet. I am praying that by next Monday, I will have them. Once I do and I go to the nutritionist for the last time, I have to give all of my documentation to the insurance coordinator at the facility where I want my surgery. She will submit everything all at once. She said within 2 weeks of submission, I will know if I am approved. So for now, its still a waiting game. Pray that my doctors hurry and send my letters to me. I want to go to the insurance coordinator right after my nutritionist appt and get this ball rolling!

Fourtunatley (or unfourtunately) my BMI is over 50. I am 5'5 anbd weigh about 325lbs. I have insulin resistance, polycyctic ovaries and hypothyroidism. I am only 26 years old and decided I want the next 26 years to be full of life and not this half-life I am living now. I want to be confident and healthy. As soon as I have more info on my journey, I will post. I will pray that you find a good surgeon and that Cigna approves you. Good luck! Trisha

[michiganer 0]

Just another update. Went to my nutritionist for the final appointment of my 6-month diet program. She said she will send me all of the documents I need plus a letter recomending the surgery. I still have not gotten the letters of medical necessity from my PCP or endo. I have called them about it a few times. My PCP said they sent it out last week. When I called today, I found out they had a really old address. Like 5 years old. I gave them my new address and they will send it again. My endo is proving to be more difficult. I saw him at least a month ago and keep getting the runaround. He is an awesome doctor so I think he gets busy and forgets. I am on his nurse like white on rice though so I am sure she will eventually make him do it. I went to my psych eval last week and am also waiting for his documents. So for now, I am playing the waiting game again. I go away for a 2 week vacation starting August 24th. Please pray that I will have everything together and will know if I am approved by then...

[bfyneNtyme 0]

Hey! I just read your email about the 6 month program, etc. You are on the right track to getting approved! Looks like you have all your ducks in a row. The Referral letter, Psy Eval, nutritionist..Have you attended a Lap Band Seminar? That maybe the only minor thing you will need to do! I will be in prayer for you...

Enjoy your vacation!

[michiganer 0]

Yup. I have been to the seminar twice and will probably go again. Thanks for the encouragement. I plan to have all my ducks in a row so they can't deny me! I will continue to update as my situation progresses...

[michiganer 0]

Ok, I am almost ready to submit all my paperwork. Yay! I am waiting on one doctor's letter and they said it was mailed to me yesterday. Once I get that it is GAME ON!

[bfyneNtyme 0]

Hello..

I'm not sure if I'm reading an old email since you have the surgery date listed as 5/23. But just incase it's not, I was approved in 3 weeks. It's true that Cigna denials usually takes place within the first 14 days.

[Sooverit! 1]

Trish....any word yet? We are all prayin for a quick and speedy approval from the almightly insurance geeks.