Daisee68

Have you met with a surgeon yet? A lot of times their office is very skilled at reading these requirements and will help you make sure they meet all of them.

It is not written very well but it does so monthly for 6 months documented which I think is referring to your dietician visits.

I would agree that is a bit vague, but by being "supervised" I would bet it is more than just one appt. I have Cigna and they specifically require 4 visits with a dietician over a span of 90 days with at least 30 days in between each appt.

Thanks so much for this. Knowing Cigna did finally approve you and within 5 days makes me feel much better. I was just so thrown by them not approving the sleep study. That document is really helpful! And even in there it says you need to rule out sleep apnea as part of pre-surgery requirements. Obviously my surgeon's office just didn't provide the correct info. You are both right that I need the time before to adjust anyway. Really appreciate the advice! Feeling much calmer about it all this morning!

I have Cigna. They require 3 months nutrition visits and psych evaluation. I plan to do those things anyway as I think they are important for success. Have already had Upper GI (discovered sliding hiatal hernia) and had Stress EKG today. My dr requires sleep study. She says 80% - 90% of her patients have sleep apnea and she is not comfortable doing surgery unless we are either told we don't have sleep apnea or treat the apnea with CPAP. My sleep study had been scheduled for tonight; however, insurance won't approve the sleep study. They said the clinic records did not show sufficient excessive daytime sleepiness that might indicate sleep apnea. I am sure dr. is going to appeal but it made me think, am I just going to have to have all these hassles all the way through the process? I can actually (blessedly) afford the surgery and wonder if perhaps I shouldn't just pay myself and not have to wait and jump through so many hoops. (For what it's worth, I am type II diabetic with 46 BMI.) I have a very stressful work schedule during the summer and really need to get the surgery done by early May in order to have a little time to focus on health before the worst of the stress hits or wait until October when it is all over (which I don't really want to wait for). I am worried that once my nutrition visits are completed (April 30), then Cigna won't approve or will hassle and have to go through appeals until we just land in mid-summer or later. So, my question, should I just self-pay and skip all the mess?

Mine is same as above - 4 nutritionist visit over span of 90 days and psych evaluation. My dr told me Cigna only recently reduced from 6 months of nutrition visits to 3.

Just wanted to say that I am so very glad you posted this! I just started the journey last week and with sleeve in mind, my surgeon informed me it was not a good idea due to acid reflux. She said we would do an Upper GI first and then I would understand. I have had a hard time getting my head around bypass, but I am starting to get there and this post really helped me feel more comfortable with that decision. I have a long way to go - psychological evaluation, sleep study for possible apnea, Upper GI, 4 visits with nutritionist (at least 31 days apart), and stress test, but honestly I am very thankful for the process as it gives me time to adjust and make some positive changes. So happy to hear others went through this same decision process - especially due to reflux!