Cigna Approval Questions

[doordie 9]

Hello! I am new to this, and I don't really have anyone that I know who has had the surgery, or wanted to so I have so many questions and I'm hoping I can make some friends here who may be able to help!

I started my diet on September 4th in preparation to see a see an obesity specialist ---

I am in my pre-approval stage, I saw an obesity specialist on Oct. 2nd who took my weight and set me up with tons of testing, and information. She specializes in using methods other than surgery to help with extreme weight loss. I did not know that when ibsaw her, so I attended a bari-seminar and was assigned a patient advocate who told me the specialist I was working with does not recommend surgery for anyone - which is confusing bc she told me she thought it was a good option for me.

Now she referred me to a family doctor and I am set to go see him this Friday Oct. 23 - My insurance calls for Three months of a medically supervised diet and I don't know what date to start from? Or even what the insurance calls for as far as a medically supervised diet?

If I choose not to go with Jenny Craig or weight watchers, and just do the plan my Dr. and I agree on - does that count? Or do I have to see a nutritionist once a month too? I have an appointment with a nutritionist, but the dates will not line up exactly! I am so confused, and between the politics of the specialist, the patient advocate telling me that the diet starts the date the Dr puts in his notes and not to worry - I am worried and a little confused!

Can anyone help?

[ImBringingLisaBack RNY 70]

Good morning!

I have Cigna Open Access Plus. I had to have a 3-month (90 days) supervised diet with either my PCP or a Nutritionist. I started with my PCP, but ultimately did the full 3 months (90 days) with my nutritionist. Once she gives the report of the 3 months diet it has to state in every appointment your weight, diet being used (mine was mindful eating) and exercises being done.

This is IN ADDITION to the Nutritional evaluation.

With my plan I could NOT gain not even an ounce. Any weight loss was OK.

All I can say is that they are SUPER picky and must have all they asked for, exactly how they asked for it or you will get denied. Happened to me twice in a week until my surgeon did a P to P with them and then I was approved in 5 minutes.

I would say either start fresh with your PCP letting him know EXACTLY what needs to go into the report for the diet notes (you can find this in your plan coverage online on their website) OR continue with the person you started it with and then will only need to do the remaining 3 apts.

Feel free to contact me if you need anything further.

Good luck!

[doordie 9]

Thank you so so much! This is incredibly helpful!!!!!!!!!