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Cigna Approval Process



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I was denied. The reason being that they need/ want another doctor (in addition to my surgeon) to clear me for surgery. Seems unfair to me since that's not one of the requirements per their policy. Also seems they should request that and then deny if it's not received instead of just denying.

No matter. My new surgeon's office has to file everything all over again anyways. Guess I'll see if my PCP can write something theyll accept as the second clearance. Hopefully thus denial won't addict that next submission. The insurance rep I spoke to this evening said it wouldn't.

The way Cigna words it is such:

"a separate medical evaluation from a physician other than the requesting surgeon that includes both a recommendation for bariatric surgery as well as a medical clearance for surgery"

In my surgeons office they say the insurance requires a separate "medical clearance" appointment- that should be your "reason for visit" I know this because I tried to get my Dr (who had been seeing me for the last 6 months- and knew every little thing about me) to write me up a recommendation and clearance for surgery and the surgeons office said that wouldn't work. It has to be a separate appointment. It was a pain- and a waste of money- but that was what I had to do to get my approval. Good luck!!!!

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My doctors office had told me it was based on patients bmi and co-morbidities. I know I've asked this many times' date=' but how long does it actually take to get a response? I has my paperwork sent yesterday 7/30. I'm probably dreaming but I'm hoping its the 5 days I've heard about. lol[/quote']

Mine was 5 days to the T. Call, call, call... I called every day to "check my file" and asked specifically where it was in the process. This is how it went for me.

July 16-17- inputting my file in to the computer.

July 18-20- waiting for RN review.

July 21,22- weekend

July 23- called in the am and was told it was with the Medical Director. Called in the late afternoon and my file was being approved while I was on the call with them.

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Mine was 5 days to the T. Call' date=' call, call... I called every day to "check my file" and asked specifically where it was in the process. This is how it went for me.

July 16-17- inputting my file in to the computer.

July 18-20- waiting for RN review.

July 21,22- weekend

July 23- called in the am and was told it was with the Medical Director. Called in the late afternoon and my file was being approved while I was on the call with them.[/quote']

Thank you i will call them today. I'm so excited and worried at the same time lol. Good luck to everyone waiting for approval ;)

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Keep calling....I rode them!

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I called everyday starting w/ the first day my surgeons office said it was submitted. I was just approved yesterday by Cigna.

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I also have Cigna insurance and I am so scared I wont be approved. I have a BMI of 52% with bilateral leg swelling when standing,and take medicine.I guess I am wondering if anyone with a BMI over 50% had trouble with insurance? I also have hypertension. I work for a hospital and have been doing my classes with the facility because everyone in town goes here for their classes. I am having my last class in on 4/16 and went ahead and scheduled my surgery around 5/23, due to my surgeon taking alot of vacations. Has anyone had issues with Cigna and needing more than 2 health issues if your BMI is over 50? I am a worry wart.

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I also have Cigna insurance and I am so scared I wont be approved. I have a BMI of 52% with bilateral leg swelling when standing,and take medicine.I guess I am wondering if anyone with a BMI over 50% had trouble with insurance? I also have hypertension. I work for a hospital and have been doing my classes with the facility because everyone in town goes here for their classes. I am having my last class in on 4/16 and went ahead and scheduled my surgery around 5/23, due to my surgeon taking alot of vacations. Has anyone had issues with Cigna and needing more than 2 health issues if your BMI is over 50? I am a worry wart.

I think with a BMI of 50+ you don't NEED the 2 co-morbidities. I would guess you'd be approved based on your bmi and health reasons as they are.

I had a BMI of about 51 with hypertension and diabetes.

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I have BMI of 39/40 with hypertension and I was approved in 3.5 days...... :) I too was a worry wart!

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I am on my last class with Cigna on April 16, and then I was told I have to wait a month to make an appointment with a dietician. Has anyone had to wait after their last class for a month,or went ahead and did the appointment.?

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