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Cigna Insurance

  • Replies 104
  • Views 9.7k
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  • waitingtoexhale
    waitingtoexhale

    I received a call today 8/26/14 informing that my VSG procedure was approved on Friday 8/22/14!! the insurance rep also stated that I have approval for the RNY too!!! Now I'm waiting on the call for

  • So I just wanted to update my process. I saw my Ob Gyn and he wrote that letter for me. Also today I got a letter form Cigna that they request more informations . I have to call the office tomorrow an

  • Jersrose43
    Jersrose43

    Actually all gastric sleeve requires a medical director to review it. Nurses and "regular" people aren't allowed to make decisions regarding medical necessity. Must be a doc Does that make sense?

Featured Replies

Oh wow that was quick!! I haven't had my 1st check up yet.....I couldn't get an appt until next Wednesday...so the drain is still in!! That sucks for me but yayyy for you!! Great job on the weightloss...yup I gotta mk these shakes work. I found an Isopure flavor I can tolerate pineapple/orange/banana but I still don't hv the energy to drink it...

I have NALC under CIGNA PPO. I've completed all of the necessary steps to get my sleeve. My doctor submitted all of my papers on 7/21/14 and as of yet, we haven't heard anything. I called Cigna and was told that they have 30 days to review but geesh, do they really take 30 days?! Does anyone here have NALC health insurance under Cigna ppo?

I have NALC under CIGNA PPO. I've completed all of the necessary steps to get my sleeve. My doctor submitted all of my papers on 7/21/14 and as of yet, we haven't heard anything. I called Cigna and was told that they have 30 days to review but geesh, do they really take 30 days?! Does anyone here have NALC health insurance under Cigna ppo?

They usually take less but have to tell you 30. Also the Nalc reviews some of these directly which is part of reason takes Longer.

  • 4 weeks later...

I received a call today 8/26/14 informing that my VSG procedure was approved on Friday 8/22/14!! :) the insurance rep also stated that I have approval for the RNY too!!! Now I'm waiting on the call for surgery DATE

I am excited for you to have gotten your approval!

I am getting extremely frustrated. I was denied(within their 5 day limit), they said because I was missing a second physician referral....which they DID already have. Then I just received a denial(on the 30th day, at 4:40pm after calling earlier that morning and asking about it they told me to call back later that afternoon) on my 1st appeal, because they said I am missing a physical exam, which they DO have! So, much surgeons office is filing a second level appeal today. I was told that this level of appeal has to be resolved within 15 days. So, keeping my fingers crossed and my faith up!!!

I am excited for you to have gotten your approval! I am getting extremely frustrated. I was denied(within their 5 day limit), they said because I was missing a second physician referral....which they DID already have. Then I just received a denial(on the 30th day, at 4:40pm after calling earlier that morning and asking about it they told me to call back later that afternoon) on my 1st appeal, because they said I am missing a physical exam, which they DO have! So, much surgeons office is filing a second level appeal today. I was told that this level of appeal has to be resolved within 15 days. So, keeping my fingers crossed and my faith up!!!

Stop sending appeals. They only allow 1

Have the surgeon office call and request a peer to peer review. That is when clinical staff talk to clinical staff.

I got my Cigna approval today! It took a week. October is wedding month, so I scheduled surgery for November 20.

I got my Cigna approval today! It took a week. October is wedding month, so I scheduled surgery for November 20.

Congratulations @@vsgchick

I finally got approved and my surgery is scheduled for September 26! I'm excited for the both of us! Congratulations on your wedding too!

Thank you! Congrats to you too. Very excited about our journey! :)

  • 2 weeks later...

So anybody else had problems with approval first go around? Cigna wanted more notes from NUT and I had to ask my PCP to write a more specific medical necessity letter. I am 5'6" and 248lb, BMI is 40.06. What do you guys think ?

So anybody else had problems with approval first go around? Cigna wanted more notes from NUT and I had to ask my PCP to write a more specific medical necessity letter. I am 5'6" and 248lb, BMI is 40.06. What do you guys think ?

If you have other doctors such as therapist for knees, back, ect. They can write a medical necessity letter.

I got my Cigna approval today! It took a week. October is wedding month, so I scheduled surgery for November 20.

. Did you have to wait long when you started the process for approval?

. Did you have to wait long when you started the process for approval?

Not too long. I started the whole process in mid-May...and approved approximately 3 months later. I had 4 nutrition classes, psych eval, labs and a stress test.

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