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Awaiting approval - Cigna

Well yesterday, Monday October 20th, my surgery center sent all of my paperwork in!!!! I am nervous and excited at the same time. But the 'what if's' are cluttering up my brain. What if I did too well on my Dr supervised died and they say no? What if they say yes?.... Since I began this journey I have been extremely cautious in how excited I am towards where I could be in a year with the surgery so if I am one of the unlucky who get denied I won't be too upset, yet if they approve... Oh my goodness where could I be with my health in just a few short months!

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  • mom of 2 poodles
    mom of 2 poodles

    Approved!!!!! Now to get on my surgeons scheduled. I am super thrilled!!!!!

  • Welcome to the " Holy crap WHAT IF club" I am the current President LOL! All those things you mentioned have gone through my mind too. I am waiting on approval too. I, like you, wonder what my body wi

  • The Candidate
    The Candidate

    @Jackbult, I love that term: Holy Crap What If Club! You should look into having that trademarked. I think I crashed your membership, hope you don't mind. :-). Even though my surgery is many months

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Welcome to the " Holy crap WHAT IF club" I am the current President LOL! All those things you mentioned have gone through my mind too. I am waiting on approval too. I, like you, wonder what my body will be in a year!

I am also waiting for approval! Good Luck to you both!

@Jackbult, I love that term: Holy Crap What If Club! You should look into having that trademarked. I think I crashed your membership, hope you don't mind. :-). Even though my surgery is many months away I often find my mind wandering into the what if future. It's a very nice place to take up residence, dreaming of how much our lives are going to change for the better!

I have faith @@mom of 2 poodles that your approval is already in hand! You too @@LisaLou30 Congratulations!

Cigna denied my surgery 3 times until i went all the way up to the appeal board the highest one. I summited a complaint with the insurance board nj. I harass them in face book lol! To the point i got a wonderful health advocate and when the dr and i thought it was going to be denied, i got the approval!! Don't give up ! Cigna is known to denied these surgery ! Complaint send letter to whoever is willing to hear.

I got approved by Cigna in less than a week...good luck to you!

  • Author

Holy Crap What If Club - love it!

I just called Cigna, and spoke with a nice girl who was able to confirm they did receive my paperwork from my surgeon's office and it is in the system. I will have an answer no later than Thursday Oct 30th... So I will be calling them in one week. The impatient part of me wants to call on Tuesday to see if they have completed it early but I don't want to annoy anyone there. But this time next week I will have and answer of go or no go!!!

@@newstartme - do you mind sharing why they denied you three times? That has me worried now...

I was just approved by Cigna on 10/21! I had been denied once, but the insurance coordinator at my surgeon's office was great and knew we just needed to send some additional documents to them. I was approved in a week once she submitted the additional paperwork. I CAN'T BELIEVE IT'S ACTUALLY GOING TO HAPPEN!! :)

They said it was not medically necessary. And that i had no evidence i follow up with my doc in colombia. It was nothing but excuses but it got approved. ????

I finally got approval from Cigna today!!!!! It took 3 try's. I had to formally appeal...but today I got my approval letter!! I'm so excited!

They said it was not medically necessary. And that i had no evidence i follow up with my doc in colombia. It was nothing but excuses but it got approved. ????

Here is the medical policy not sure where it says you have to follow up with someone. Also Cigna sells to many - employers can make their own rules, they sell to other insurances who also can make additional rules but thy have to be in your spd

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

Here is the medical policy not sure where it says you have to follow up with someone. Also Cigna sells to many - employers can make their own rules, they sell to other insurances who also can make additional rules but thy have to be in your spd

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

I got approved because i wouldn't let go the fact the excuses they gave me weren't on the policy. I am an hr manager so i directly contacted the benefits administrator from my employer and made a bit of noise in corporate lol!
  • Author

Approved!!!!! Now to get on my surgeons scheduled.

I am super thrilled!!!!!

  • Author

today i got my surgery date!!!!!

November 20th!!! wow, when things get moving they get moving!!!!!

Grats!

Wow....I'm so happy for all that were approved by cigna...congrats and good luck!! I however, was not that lucky. I was denied and then my surgeon had a peer to peer on Thursday...DENIED!!! My BMI is 32.5 so basically it was cut and dry, no sleeve If under 35 even with co mortalities. I actually cried to the poor surgical coordinator...my band was removed sept 19 and I have gained almost 30 lbs! So, I have to gain 20 more to get the sleeve, maybe, or I can probably get another band...wtf!!!! I was told that there is no appeal once the peer to peer has happened....can I appeal???

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