Cigna insurance

[sissytx 4]

I have my first appointment on 1/15/13. Any advise with Cigna? My pcp is writing the referral. I have over 6 months on Jenny Craig, currently going to weight watchers. My insurance will cover this. The doctor is in network. I have 3 co mor but my BMI is only a couple of points over the 35. Do I need to show that I had a gym membership? Like most of us I have done lots of research, I know what I will have to do to be a success and am ready to get going. Any help moving the process would be greatly appreciated. Thanks in advanced

[autumn_moon 9]

Where are you getting banded? I went through Oregon weight loss surgery and they took care of everything with Cigna plus they had a step by step procedure of everything I needed to do. They have dietitians, pt and psychologists on staff. I had to meet with the psychologist once for 30 minutes and dietitian and pt once a month for 3 months. The good thing is you don't have to go on a diet before the surgery. But, you can't gain weight. I could give you more details if you need them. Cigna has a website too that has everything you need to do on it. They turned me down twice before they approved it. The only thing that I can see is your BMI is low. Check their website for what your BMI needs to be.

Good luck, Vicki

[sissytx 4]

I just wanted to be super per-prepared with all that I need prior to my consult. I will be banded in Fort Worth, Texas. Thanks for the info.

Sheila

[babykins529 189]

I have Cigna and was tokd they are one of the hardest insurances to get approval from. I too am in Oregon (along with Autumn) but and going next door to Legacy weight and diabetes to see Dr. Halpin. I've talked to Cigna and the nice lady at my clinic who takes care of the insurance. Cigna requires at least 3 months of supervised nutrition classes which they don't cover and are around $200 each. 5 years of weight history from a doctor. At least one documented weight per year. A letter from your PCP (on top of the referral letter) stating why they feel you need bariatric surgery. And then the BMI requirements which you already know. On top of any hoops the bariatric clinic will make you jump through. I had the seminar, the welcome class, REE, sleep study, EKG, blood tests, 3 nutrition classses (my last one is jan 9th) saw the psychologist, physical therapist, nurse practioner and the nutritionist and finally the surgeon. They are submitting my paperwork right after my last nut class on the 9th. Then it will take approx 2 weeks to hear back from them. My seminar was on September 26, 2012 to give you a time line. I did post what Cignas requirements are on a different post if you just type in Cigna in the search area. Best of luck!

[babykins529 189]

Go to www.cigna.com and enter 0051 in the search and there is all the requirements.

[babykins529 189]

Darn, I guess that doesn't work. I just tried doing it. I did it once back in October and it worked. What I would do then, is call Cigna. Sometimes you will need to talk to more then one person to get the correct answers. The first lady I talked to didn't even know what bariatric sugery was. The second was much more helpful.

[sissytx 4]

Wow, thanks for all the info.

[sissytx 4]

Babykins,

Did Cigna require all that. From what I read my Jenny Craig records can be used. I go see my pcp every 3 months for diabetes. I knew I would have to have the pyc examine and meet with a nut. I can private pay if necessary but rather have ins help. I have three co-, diabetes, high blood pressure and colesteral . I have at least 6 years of history with my weight.

I guess I will find out what hoops I have to jump through in 2 weeks.

[babykins529 189]

I had months of Weight Watchers weigh-ins, but even though they say they take those types of weigh-ins, it says by a physician or licensed dietitian. Um, I don't know about Nutra System, but Weight Watches doesn't have either, at least not the one I went to. Which is really dumb in my opinion because the insurance KNOWS they don't have that. I've been back and fourth with my clinic and insurance. I would talk to your clinic and insurance and make triple sure they will except it. I decided to not bother trying since I've pretty much done everything they've required. I am so afraid to get turned down that I'm paranoid about having everything perfect.

[autumn_moon 9]

http://www.cigna.com/assets/docs/health-care-professionals/coverage_positions/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

You don't have anything to worry about. Legacy will walk you through every step of the way. Shannon is a pro at dealing with Cigna. I was rejected twice and she never gave up.

I almost think they have to do that in order to approve it. You will love the folks at Legacy they are so supportive and walk you right through it.

Hope this helps, Vicki

[autumn_moon 9]

My daughter was banded when she turned 30 and dropped 125 pounds. She's kept it off for over 5 years, she's the one who inspired me. I think it's important to enjoy your life and be the person you were intended to be. Dr Halpin was my surgeon along with a resident from Mexico who is incredibly nice. I cannot say enough nice things about Legacy Hospital, they took such good care of me I thought I died and went to heaven..LOL I've been in a lot of hospitals in my lifetime, and I have never been into such a warm, caring hospital as Legacy. From the receptionist that checks you in to the cleaning staff. Your in good hands.

[poohda04 0]

I wanna.know to you go about trying to get the surgery do get your doctor to inform the insurance company

[jms413 17]

i have cigna and at first it requires 6 month diet but found out from people on this website that it changed to 3months which was perfect so my surgical office called and had cigna send them that info on paper. also required psyc evaluation and reccomendation from my primary doctor . i was approved and banded 12/19

[babykins529 189]

Helps a lot, thank you. Yes, Shannon was the one who caught the needing the 5 years of weights and the letter from my PCP. It slipped passed Karen who does the insurance. I'm hoping it only takes the two weeks, obviously the sooner the better! Thank you Autumn.