I am in Delaware with Cigna OAP.
Through my surgi center we have to:
required WLS seminar
surgical consultation
GI endoscopy w/ surgeon
Psych consult (she required me to start weekly sessions with a therapist and see a nutritionist 1 on 1 before she cleared me)
Cardiologist consult (EKG and Echo)
Pulmonologist consult for a pulmonary function test (I also had to have a sleep study as I never had one before)
3 months of nutrition classes through the joint Weight Loss Institute's program (to satisfy cigna's requirement)
3 life skills classes about the sleeve
Blood work
Medical clearance with endocrinologist (CLEARED! YAY)
Endo submits case findings back to Surgeon's office. Surgeon's insurance case manager creates/compiles case to send to insurance company (ANXIOUSLY AWAITING AN ANSWER FROM CIGNA UGH)
Then...
Surgical clearance
2 weeks opti-fast
I am so afraid I will be denied. My surgeon's office (Christiana Institute of Advanced Surgery) works exclusively with Eugene Dupont Preventative Medicine and Rehab institute. That's where they send you for the visits with the endo, nurse practitioner, psychologist, nutritionist one on one, nutrition classes and life skills classes. So everything stays in one place and is worked on by the same people. I am hoping that will help me get approval. If I have to wait any longer for Cigna to approve me I may explode.