Just starting the process...advise wanted

[doubleg71 0]

I made my initial consultation today and my BMI was 41.5. I have Cigna OAP and have taken the time to read many of the posts on this site to prepare myself for everything. I have a couple of questions and hope to find some advise in order to limit the amount of time that I waste with Cigna. I have a 2 yr weight history of 39-41 BMI with my PCP and I am hopeful that I will not be denied. It seems to me that many people have had to have their PCP write a letter of recommedation before they are approved. Should I make an appointment with my PCP and begin the process with him prior to beginning the weight loss program or just wait? Secondly, if Cigna denies me, like they seem to be doing with many people, how soon in this process will it take before I find out that they are denying it...before or after the 6 month program?:thumbdown:

[Brockbabe82 0]

I think it definitely won't hurt to have more documentation from your pcp! I have found the more documentation, the better! Good luck to you! I hope to see you banded very soon!

[adagray 1]

I talked to my PCP about WLS before I chose a bariatric surgeon so I let her know at that time that I would need a letter of medical necessity. Personally, I think its a good idea to meet w/your PCP earlier rather than later in the process. You will need that letter and if your PCP is not supportive, it would be best to find out right away so you can change PCPs, if needed, to get the support you need. If you already have things rolling w/your bariatric surgeon's office, though, I wouldn't delay starting the 6 month diet. Just meet w/your PCP and get that letter as soon as its convenient for you.

As for whether you can be approved before or after the 6 month diet, my paperwork from Aetna says that you can submit before the 6 month diet is completed and they can approve you 'contingent on completion of the 6 month diet'. Originally, this is what I had planned to do. The insurance coordinators at my surgeon's office highly recommended against that. They said it puts up red flags if you submit without everything completed and that it might cause me to use up an appeal. I'm putting my trust in them since they are the insurance experts.

As of tomorrow, I will have completed the 6 month diet and everything else and my stuff will be submitted to insurance. Ack! I'm so nervous!!! But, I just keep reminding myself if I get denied, it is not the end. Lots and lots of people on here get denied, but then approved later on appeal. So, we just gotta stay strong and hang in there.

Best of luck to you!

[doubleg71 0]

adagray - Thanks for the advise and I will take everything that you have advised me of to heart. I will be beginning my six month program soon and I am plan to do everything that is required of me. Wish me luck for a successful program:thumbup: