Anxious over approval ????

[AllthingsApple 34]

Hi All,

How long after being informed that your packet was submitted to your Insurance company did you start calling and following up? Also has anyone had success getting their Dr's office to call and expedite things? I was submitted on Monday and have called about 4 times already in 3 days.

Thanks in advance everyone!

[AllthingsApple 34]

Some good news! I should have an answer within 48 hours. So I'll give them a break tomorrow and call back Friday????.

[thinner-me 160]

Wow! That was fast! I was told that the insurance companies sometimes take up to 1 month to get back to them. Avg is 2 wks. I hope mine is as fast as yours as I am a teacher and REALLY wanting to get this done this summer! Good luck!

Edited June 25, 2015 by thinner-me

[Running2theSleeve 40]

I was told a pre-cert can take up to 30 days. I think that's just standard and what they are trained to say if they do get behind.

Same as Shipping 7-10 business days but you get it in 3 days????

@@AllthingsApple ... Best of luck! Keep us posted!

[majorsmama 91]

My surgeons office said 2 weeks but it only took 3 days.

[Scarlett72 13]

Only 4 days for me.

[AllthingsApple 34]

Well 48 hours from last Wednesday has now been moved to July 1st. But that's okay since its in review and not denied status. No news is good news I guess?????

[AllthingsApple 34]

UPDATE: I was denied by Cigna.

The reason..."the Doctor needs to provide more clinical notes". When asked what EXACTLY was needed in these clinical notes, it he rep said,"well I don't have access to the pre-certification database but they will send a letter to the Dr".

Disheartening to be made to jump through all of these hoops AND continuously be down in weight at each required visit just to be told we need more notes.

[1SlimmerMe 122]

@@AllthingsApple keep your head up. I'm sure your doctors office knows the verbiage to use to get it approved. Look on the bright side, at least it's just doctor's documentation and not anything else.

Edited July 10, 2015 by 1SlimmerMe

[AllthingsApple 34]

Thanks for the support @@1SlimmerMe! I've calmed down considerably from yesterday????. It's out of my hands until my Dr comes back from vacation and can provide another letter of recommendation. You're right, at least it's an easy fix and nothing really major.

[The Candidate 3,215]

I don't have Cigna. I just wanted to say hang in there and don't lose faith. Appeal if you have to but never give up. Best of luck to you!

[Scarlett72 13]

Sorry to hear there's been a snag in your approval. Sounds like you will be approved after they get your doctor's letter though. So that's good. Hang in there, soon you'll be on your way to your new improved self!????

[AllthingsApple 34]

UPDATE: So, my Dr returned today from vacation and wrote me an updated letter so my paperwork has been resubmitted. According to the Insurance Coordinator, she should hear something by next week if not sooner. I'm just keeping myself busy and continuing to make good food choices and staying active so I'm not so focused on the time until a decision.

[Jersrose43 837]

Please read Cigna medical policy attached. The letter needs to be from a doctor that is NOT your surgeon. Must be a doctor who has treated you like a pcp or ob gyn and must document all failed attempts to lose weight in the past.

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

[Cheers2Happiness 28]

Staying busy is good! You'll stress yourself out thinking about it. Lol I was scheduled to have surgery June 22. First Cigna said they didn't receive clinical notes, then 4 days before surgery they denied me because they said although I went every month to the nutritionist for 3 months it didn't equate to 90 days or more. Definitely bummed, I started the 3 month medically supervised diet program again in June. But surprisingly I got a call last week that my surgeon appealed and did a peer to peer review and it was approved. I'm scheduled for surgery in a couple hours (Too anxious to sleep). These insurance companies sometimes want to discourage you because they don't want to pay. But it's in your policy, it will definitely be approved one way or another! Wishing you the best of luck!!!

Edited July 9, 2015 by Cheers2Happiness