oscarel 0 Posted February 12, 2008 Hi all. I'm new posting to this forum, but I've been reading for a few months now. I'm 2 months into the required 6 month diet period now. The question I have is AIGB in Richardson is not considered "In Network" by Cigna. I'm being told that AIGB will honor the "negotioated" rates with Cigna but they will not know what that rate will be until after the surgery. I'm told the most I will have to pay is the balance of the "In Network" out of pocket costs. Now I know it's better than having to pay for the whole thing myself, but can someone shed some light as to what they actually had to pay, or what their negotiated rate ended up being? Thanks in advance. Oscar Share this post Link to post Share on other sites
MirandaK 0 Posted February 12, 2008 I am also using AIGB but in Hurst. I am 2 month in to the 6 month diet so I don't know what the final cost will be but I do know that Dr Marsden will do the surgery and he is a cigna network docter. Maybe it would be worth going to the Hurst office instead of Richardson. I do know my plan only has a 400.000 deductable and a 1000.00 out of pocket. So the most I will have to is $1400.00, but by the time I get the surgery I would have already reach my deductable so 1000.00 is what I should have to pay. Share this post Link to post Share on other sites
oscarel 0 Posted February 12, 2008 Thanks MirandaK for responding. You know that's the one thing I didn't check was to see if the doctor was in-network, I'll look that up now. Share this post Link to post Share on other sites
oscarel 0 Posted February 12, 2008 Ok, for the 4 doctors that show up on Trueresults.com for the Dallas office, Dr. Marsden and Dr. Fox show up for Cigna. So I guess I'll have to contact AIGB again tomorrow and inquire about it again. Share this post Link to post Share on other sites
Joaquin 0 Posted February 13, 2008 I went through AIGB in Hurst, Dr. Marsden did my surgery on 1/21 and I have Cigna. I was only out of pocket $200 for the surgery. Cigna does not cover Dr. Marsden fills so I may have to go to the surgery center where they are considered a regular doctors visit or go to another surgeon. The only reason that I am hesitant about going to the diagnostic center is because they do the poke and fill and they don't use the xray. ( Or so I have been told). I will have my first 2 fills with Dr. Marsden because he covers those but then I will need to make some decisions. By the way I really like Dr. Marsden and I really don't want to change surgeons. Share this post Link to post Share on other sites
oscarel 0 Posted February 13, 2008 Thank you both for the comments. I will definately be looking into this more before the surgery. One more question. Did ether of you have to provide more than 12 months proof of obesity? I've got the document provided by Cigna "mm_0051_coveragepositioncriteria_bariatric_surgery.pdf" that states "BMI (Body Mass Index) ≥ 40 for at least the previous 12 months" but AIGB insists they need 5 years. This isn't that big of a deal, just wondering. Share this post Link to post Share on other sites
Joaquin 0 Posted February 13, 2008 I submitted 5 years but they told me that Cigna only required one. Share this post Link to post Share on other sites
MirandaK 0 Posted February 14, 2008 I only have to show 12 months for Cigna. Also have to have one visit with a Nutrition and have a psychological exam. True Results will try to push the sleep study on you but if you are over 40 bmi you can refuse it. Cigna does not require it. So I refused it. I have my 12 month weight loss hstory and my nutrition visit done. So I just have the psychological exam and 4 more visits left. Just think when you go in next onth you wil be half way there. Share this post Link to post Share on other sites
oscarel 0 Posted February 14, 2008 That's what I thought, but AIGB seems to believe they need 5 years. I have my psych exam scheduled with my next visit. The receptionist said it was 2hrs and there was a 350 question exam!! Boy, I'm not looking forward to that. Luckily they didn't push/question me about the sleep test. 4 more months!! Share this post Link to post Share on other sites
boo1974bear 0 Posted March 18, 2010 That's what I thought, but AIGB seems to believe they need 5 years. I have my psych exam scheduled with my next visit. The receptionist said it was 2hrs and there was a 350 question exam!! Boy, I'm not looking forward to that. Luckily they didn't push/question me about the sleep test. 4 more months!! The sleep study is not to just see if you have apena. It's also to make sure you won't have any breathing issues while your under anesthia. At least that is what I was told. And I had my psych exam in late 2008 and last week with Dr. Kennedy. (Didn't know I had to be with my insurance company for three yrs for the band to be covered. So had to redo the psych and nutrition part. Will be getting the band after 6*14*10) True Results in Hurst recommended him. I was there for less than an hour. And I was asked less than twenty questions. Share this post Link to post Share on other sites