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Ok WOW, CigNo cont'd

Hey Ladies and Gents,

It's me again...this time with another Cigna tidbit. So, today I called Dr. Pinnar Surgery Associates in Reston (already came to the conclusion not going with them because of the astronomical program fee of $2500) and spoke with the RN in regards to seeking approval from Cigna Insurance. She said that she has been doing the job since 2002 and has never seen a Cigna approval. I was flabberghasted and couldn't believe it. Surely, I thought, someone had Cigna insurance and received approval. Well, according to her they had not. My boss mentioned that maybe its because Cigna didn't agree with their policy (which includes $1500 paid up front and then an extra $1000 paid in monthly install ments following surgery - it includes among other things, first three fills (not covered???), nutritionist evalations before and after surgery, paperwork and just general correspondence between office and insurance company).

Also, I told her (the RN) how I had gathered the 6 mos thing (kinda-shrug) as well as am about to finish physical, but also have recommendation letters from PCP, Therapist, Orthopedic doctor, Gynocologist and Neurosurgeon. She said that letters only worked on the 1st appeal, after you got rejected the first time. But I'm thinking what the h - e - double hockey sticks, I'm going to submit the major requirements including recommendation letters and my heartfelt letter and see how it goes. If I get rejected, then I'll try again.

ALSO, the physician I am planing to go with does the REALIZE band, other than the LAP-BAND. Any thoughts, opinions?? I love this website and truely appreciate the comments and advice that you individuals have given me. As well as the updated Photos and blogs. :thumbup:Keep me in prayer and I will do the same for you as well.

Edited by krasc001

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My doctor used the Realize band for me. Personally I think some people get hung up on the brand name of LAP Band because it was first. I would ask the doctor why they only use Realize or why they want to you use it on YOU. That way you are getting a medical answer as apposed to a what a bunch of non doctors think about a brand name.

I got approval from Cigna and didn't have any problems other than going through the 6 month wait. Not sure what kind of band I have.

Kansas University only uses lap band and they are a center for distinction. The new lap band has sections so it is like little pillows on the inside that grips better and less chance of slippage.

I have never heard of an office that has never had an approval from Cigna. I have Cigna and they approved me. My surgeons office works w/ Cigna (along w/ lots of other insurance) all of the time. Cigna will approve as long as you submit everything they ask for. My policy required a 6 month Dr. supervised diet, nutritionist visit, sleep study, letter of medical neccessity from my PCP and psych evaluation.

You may need to chose a new surgeon if these people are telling you they never get an approval from Cigna.

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