Anyone approved by Cigna?

[MyBandJourney2009 0]

Hey all,, yes, the waiting game for approval seems like it will be harder than the 6 months of pre-approval criteria the insurance company said I would have to do. I finished all of that last week and it's now on it's way to Cigna for approval. I was just wondering if anyone here has Cigna insurance? And if so, how is your process going. I'm praying for a speedy and non eventful waiting period:thumbup:

[Carrie_C 9]

Hi, I have Cigna. I had surgery May of last year. Did you have your nutrition and psych consults? They will deny you if you haven't had those. You also have to have the letter of medical necessity. If you have all of that in with your 6 month diet, it shouldn't take long for you to be approved. I was denied the first time, but it was only because the doctor's office didn't fax everything in the first time. Once Cigna received everything, it only took a little over 2 weeks for them to approve me. Good luck!

[tgilley 0]

I had Cigna as well. The doctors staff was excellent at getting all the required information to them and also did follow up calls each week. It was "in review" for almost 3 weeks and then approved.

[ERIKA79 0]

hi there, i am just starting my info collecting journy for all this. I too have cigna, if you do not mind, could you tell me a little more about the process of what I should do to help get this approved?? Any info would be super appreciated!!!

Thanks,

Erika:confused:

[Dana36 0]

I have Cigna and am waiting to see if I have been approved.

Erika,

First call you insurance company and make sure that your policy covers weight loss surgery. Just because Cigna covers it, it doesn't mean that all policies have it included.

If it is covered, then you need to go get several things done. They require 6 months of monitored attempted weight loss by a physician. They require a letter of medical necessity from a physician who is NOT doing the surgery (I had my pcp monitor me for 6 months and write the letter). They will also require you to see a nutritionist (my surgeon made this appointment for me), and you will need to be cleared by a mental health provider (again, my surgeon put me in touch). Then you will need to provide medical records of morbid obesity and any information about any comorbitities that you might have. I have been told two different things on this, 2 years of records, and 5 years of records. I gathered 5 years of records just to be safe.

You surgeon and his/her office should walk you through every step of this. Good Luck!

[MyBandJourney2009 0]

He Erika,,, Yep, Dana is right,,, that's all the stuff that Cigna will want. When I first started my jouney, I was at a seminar that my surgeon does. There was a lot of paperwork that he asked anyone that was seriously considering surgery to fill out for him. About a week later, his office called me and said they had heard from Cigna and that it would be covered. I had my first one on one appointment with him and he went over all the things Cigna would want. 6 months/6 appointments with my doctor for weight loss management, dietitian and psyc eval. I finished all my 6 months of appointments last week and am now waiting for my doctor's office to send the letter of need to my surgeon. That is the last piece of paper that Cigna will ask for. My surgeon doesn't even send it to the insurance till he has everything they will ask for. The 6 months went by MUCH faster than I thought it would, but the past week waiting for that ONE letter is driving me crazy, lol.

Dana, you mentioned something about 2 to 5 years of medical records,,, my surgeon has said nothing about this. I hope that's not a hurdle I'll have to do??? My surgeon said that the 6 months were for a record of weight loss since sometimes it's hard to find past weight loss records.

Well,,, that's where I'm at right now. I'm praying that I wake up tomorrow and find an email from the surgeon's office saying they have the letter and have sent Cigna all the paperwork! Good luck to you both, keep in touch with your Cigna process! :-)

[ERIKA79 0]

thanks a bunch for your info..I am meeting with a dr tomorrow and this will really help me get my ducks in a row!

[Dana36 0]

He Erika,,, Yep, Dana is right,,, that's all the stuff that Cigna will want. When I first started my jouney, I was at a seminar that my surgeon does. There was a lot of paperwork that he asked anyone that was seriously considering surgery to fill out for him. About a week later, his office called me and said they had heard from Cigna and that it would be covered. I had my first one on one appointment with him and he went over all the things Cigna would want. 6 months/6 appointments with my doctor for weight loss management, dietitian and psyc eval. I finished all my 6 months of appointments last week and am now waiting for my doctor's office to send the letter of need to my surgeon. That is the last piece of paper that Cigna will ask for. My surgeon doesn't even send it to the insurance till he has everything they will ask for. The 6 months went by MUCH faster than I thought it would, but the past week waiting for that ONE letter is driving me crazy, lol.

Dana, you mentioned something about 2 to 5 years of medical records,,, my surgeon has said nothing about this. I hope that's not a hurdle I'll have to do??? My surgeon said that the 6 months were for a record of weight loss since sometimes it's hard to find past weight loss records.

Well,,, that's where I'm at right now. I'm praying that I wake up tomorrow and find an email from the surgeon's office saying they have the letter and have sent Cigna all the paperwork! Good luck to you both, keep in touch with your Cigna process! :-)

If you look on Cigna's website at the bariatric surgery info, it no longer says anything about having to have 2/5 years documentation. When I first started this process, it said 2 years. Several of the customer service reps that I spoke to said that I needed 5 years.. so my surgeon and I decided to get together 5 years of history just in case.

[Carrie_C 9]

He Erika,,, Yep, Dana is right,,, that's all the stuff that Cigna will want. When I first started my jouney, I was at a seminar that my surgeon does. There was a lot of paperwork that he asked anyone that was seriously considering surgery to fill out for him. About a week later, his office called me and said they had heard from Cigna and that it would be covered. I had my first one on one appointment with him and he went over all the things Cigna would want. 6 months/6 appointments with my doctor for weight loss management, dietitian and psyc eval. I finished all my 6 months of appointments last week and am now waiting for my doctor's office to send the letter of need to my surgeon. That is the last piece of paper that Cigna will ask for. My surgeon doesn't even send it to the insurance till he has everything they will ask for. The 6 months went by MUCH faster than I thought it would, but the past week waiting for that ONE letter is driving me crazy, lol.

Dana, you mentioned something about 2 to 5 years of medical records,,, my surgeon has said nothing about this. I hope that's not a hurdle I'll have to do??? My surgeon said that the 6 months were for a record of weight loss since sometimes it's hard to find past weight loss records.

Well,,, that's where I'm at right now. I'm praying that I wake up tomorrow and find an email from the surgeon's office saying they have the letter and have sent Cigna all the paperwork! Good luck to you both, keep in touch with your Cigna process! :-)

I didn't have to have 2-5 years of medical records either. I don't think it is required anymore as long as you have a letter of medical necessity from your PCP. Just FYI, Cigna will probably mail you the letter first informing you if it has been approved before they let the doctor's office know. That's how it worked with me anyway.