LoosingIt67 1 Posted July 14, 2015 After reading quite a few topics here I realized that my sleeve is being handled a bit differently. First and foremost, a bit of background. I'm 48, 5'4 with a BMI of 35.3. I'm covered by Cigna. 10 weeks ago was my initial visit with Dr.Sadek, Director of Bariatric surgery at Robert Wood Johnson. It was my orientation. I walked out with a surgery date (7/31) and a list of the doctors that I need clearance for the procedure; a letter of medical necessity from my PCP, along with five years of weight management records, a clearance from a pulmonary dr, gastroenterology clearance, cardiologist ok, & of course a clearance from a nutritionist. Being on a smaller side Cigna requires at least one comorbidity. As it turns out I am pre diabetic, have a mild sleep apnea, & mechanical arthritis. I've undergone an upper gi, a colonoscopy, a nuclear stress test, & an ultrasound of my torso neck and legs. So it seems that I've got enough for an approval. My concern is, that from all the posts that I'm reading here, you all get approved first and then go through the test and only then get a surgery date. In my case, the Bariatric Surgeon will submit my case on the 17th of July. I'm even scheduled for July 17th pre op testing. But I'm very concerned that it won't be enough time for Cigna to approve. Am I the only one who is going through the process kind of backwards? Share this post Link to post Share on other sites
LoosingIt67 1 Posted July 15, 2015 I guess I am the only one. Disappointing about the lack of responses. Share this post Link to post Share on other sites
RNsleever715 117 Posted July 15, 2015 I'm private pay so I can't help... Hope someone else can! Share this post Link to post Share on other sites
fldianna 8 Posted July 18, 2015 I have Cigna, but I have to go through 3 months of physician monitored weight loss. I called Cigna before seeing a surgeon and Cigna scheduled a health coach call for me to start the process. I would suggest calling Cigna. Hope this helps. Good luck. Share this post Link to post Share on other sites
Jersrose43 837 Posted July 18, 2015 I have Cigna. I met with surgeon. Then several months later the EGD then the colonoscopy During the three month period of preparing I did the abdominal ultrasound as required by surgeon, the cardiologist visit and got the letter from my PCP. After I did all that they submitted to insurance and then scheduled my surgery after it was approved. Share this post Link to post Share on other sites
Nora82 11 Posted July 22, 2015 I am an insurance coordinator for the surgeon who did my sleeve. We schedule all preop appointments and tests at the initial consult. If you've got everything your insurance requires it can be a quick process. Our fastest was 3 weeks from initial consult to surgery. Share this post Link to post Share on other sites
Running2theSleeve 40 Posted July 23, 2015 I have BCBS IL and my surgeon won't even submit to my insurance until I have the PCP, Pulmonary, Psych, Bloodwork and EGD clearance. I also have to meet with an exercise specialist and attend a meeting at least once. This is the surgeon's requirement not my insurance. Saw my PCP today and he wanted an EKG along with it. I would rather it this way then to get a surgery date first and plan with hopes high just to run into a hurdle. Plus this way gives the insurance more documented facts to assist with the approval. Bottom line my surgery will not be scheduled until after approval. It's like the surgeon gave you a spot but then what if it's a delay ... To many what if's to me to schedule without approval. I'm almost done! Share this post Link to post Share on other sites