I am finally finishing up my 90 day pre-op diet. I've successfully completed every other requirement by my insurance (psych evaluation, bariatric classes, nutritionist appt, etc) and my last pcp weigh in is in a week. I spoke to my patient advocate today to make sure my ducks were in a row for approval and she now says, for the first time today, that she needs medical records from 2013 and 2014 showing my BMI was over 35 since then. My BMI was under 35 in 2013 and nowhere in Cignas requirements (I've read the policy many times and called Cigna many times) does it say anything about needing two years of past records for approval. When I told the patient advocate this she told me they always ask for it. Does anyone have any info on this because I'm at the pre-op finish line and now this is thrown at me, and I'm devastated.

I also have Cigna and they required a second opinion from a doctor other than my surgeon recommending I have the procedure. Once that was sent in I was approved. I'm all set for July 20th. Start my pre-op diet on 7/3. Whew. Started the process in February so it hasn't been too bad. I'm not a patient person so I'm glad I have a date now. I've got my ducks in a row and am ready to move forward with this new chapter in my life.

Would a GP be considered a second opinion? He is the one who told me I would qualify and suggested it to me.

Yes, he just needs to provide a letter to your surgeon's office and they can submit everything together. I was denied at first because I didn't have the second opinion. Once they submitted that piece I was approved within a week.

What other requirements did you need to meet? Three months or six months of starvation with no results before you could have the procedure? ????

3 months of weightlessness as appta with your doc, but you don't have to lose a set amount of weight. I didn't lose any. It actually ended up being 4 appts total.

This link will give you all the requirements for Cigna.

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

I have cigna as well and my stuff was suppose to have been submitted on 6/18. I have not heard from cigna yet. I am very nervous. I am worried that she may had not even submitted it bc she has been very forgetful. I have my fingers crossed to get an approval this week.

Thank you everyone! Good luck with your submission. Fingers crossed your approval is quick! I am really trying to gauge my expectations but don't want any delays at the same time.

@megieg: I call Cigna everyday. I apologize to them but remind them that to them, it's just a job, but to me, it's my life. Cigna reps are usually very understanding so maybe you should call. PS: I still don't have an answer so not sure calling helps.

I agree calling to check in the status is a good idea. Not to make a pest of yourself but to be your own advocate.

I have cigna as well and my stuff was suppose to have been submitted on 6/18. I have not heard from cigna yet. I am very nervous. I am worried that she may had not even submitted it bc she has been very forgetful. I have my fingers crossed to get an approval this week.

It's nerve wracking, isn't it? My info was supposedly submitted on 6/19 and my surgeon said approval should only take 2-3 days. I haven't heard anything yet and I jump every time the phone rings.

@megieg: I call Cigna everyday. I apologize to them but remind them that to them, it's just a job, but to me, it's my life. Cigna reps are usually very understanding so maybe you should call. PS: I still don't have an answer so not sure calling helps.

Thank you for the idea l I called this morning. Cigna stated that they received it on the 22nd which was last Monday is still pending fingers crossed I hear something soon

I have cigna as well and my stuff was suppose to have been submitted on 6/18. I have not heard from cigna yet. I am very nervous. I am worried that she may had not even submitted it bc she has been very forgetful. I have my fingers crossed to get an approval this week.

It's nerve wracking, isn't it? My info was supposedly submitted on 6/19 and my surgeon said approval should only take 2-3 days. I haven't heard anything yet and I jump every time the phone rings.

yes it is very nerve-wracking I called Cigna this morning they stated they received it on the 22nd she did tell me that it look like it was pending for inpatient surgery on August the 28th so falls approve it looks like my date to August the 28th . Hope I get approved soon

Woo hoo!!!

I am finally finishing up my 90 day pre-op diet. I've successfully completed every other requirement by my insurance (psych evaluation, bariatric classes, nutritionist appt, etc) and my last pcp weigh in is in a week. I spoke to my patient advocate today to make sure my ducks were in a row for approval and she now says, for the first time today, that she needs medical records from 2013 and 2014 showing my BMI was over 35 since then. My BMI was under 35 in 2013 and nowhere in Cignas requirements (I've read the policy many times and called Cigna many times) does it say anything about needing two years of past records for approval. When I told the patient advocate this she told me they always ask for it. Does anyone have any info on this because I'm at the pre-op finish line and now this is thrown at me, and I'm devastated.

I too am waiting for Cigna to approve and give me response. They say it will be this week. I will let you know if I have same issue. I too did everything I was suppose to in the 90 days and I was never told about medical history. I read the requirements too many times. I will keep my fingers crossed for you. Don't panic, your doctors office deal with the insurance companies every day and I am sure they will help you come up with solution. You have come so far to give up, but I would probably react the same. Keep in touch

Sue