Cigna questions-frantic

[smkallen67 31]

I am finally finishing up my 90 day pre-op diet. I've successfully completed every other requirement by my insurance (psych evaluation, bariatric classes, nutritionist appt, etc) and my last pcp weigh in is in a week. I spoke to my patient advocate today to make sure my ducks were in a row for approval and she now says, for the first time today, that she needs medical records from 2013 and 2014 showing my BMI was over 35 since then. My BMI was under 35 in 2013 and nowhere in Cignas requirements (I've read the policy many times and called Cigna many times) does it say anything about needing two years of past records for approval. When I told the patient advocate this she told me they always ask for it. Does anyone have any info on this because I'm at the pre-op finish line and now this is thrown at me, and I'm devastated.

I too am waiting for Cigna to approve and give me response. They say it will be this week. I will let you know if I have same issue. I too did everything I was suppose to in the 90 days and I was never told about medical history. I read the requirements too many times. I will keep my fingers crossed for you. Don't panic, your doctors office deal with the insurance companies every day and I am sure they will help you come up with solution. You have come so far to give up, but I would probably react the same. Keep in touch

Sue

[MrsRoboto 370]

I just called Cigna to check my status and they said they had never received anything! I seriously wanted to cry. My doctor said they were submitting everything on 6/19 and it would take 2-3 days. I waited all last week for my call. SO frustrating and disappointing. So I called my doctor's office and she put me on hold and then came back and said I was on top of the pile and would be the next to be sent off. After all these months this has to be the hardest part. I am so ready and I've done all I can do. Now I just have to sit here and rely on other people to do their parts.

[xrayyoung22 16]

I would be so upset too. I'm sorry. That is tough but I'm glad you called.

[Catherine Davis 36]

I feel really sorry for you guys in the US with all the running around you have to do for your insurance to pay for WLS. I'm in Australia, and all we do is select a level of health insurance with Bariatric surgery cover, and if it is a higher level of cover sit through the waiting period (usually 12 months). You need a referral from your gp to the Bariatric surgeon of your choice. Then Medicare pays part of the cost, insurance pays part and you can get a medical loan or early superannuation payout to pay the gap (in my case approx $5000-$6000). So much easier ! ????

[xrayyoung22 16]

Soooo, I got the call today!!! My surgery is scheduled for June 20th!!! I cannot even express my excitement right now!!!

[Catherine Davis 36]

Soooo, I got the call today!!! My surgery is scheduled for June 20th!!! I cannot even express my excitement right now!!!

Congratulations! I hope it goes really well for you ????