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Pre-op timeline... Help!



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Hi all :) I'm Keri. I wasn't sure if this should go under the Insurance/Financing forum or not but thought I might get more feedback in here.

I was hoping somebody could clear something up for me... I know Cigna requires >89 days (I just say 90) weight management for the pre-op aspect, but I'm confused about how it works exactly.

I was told by the 'nurse navigator' who submits everything to insurance that the only visits that count would be with the bariatric Doctor/NP and nutritionist. But is there a specific timeline I'm supposed to be following between visits? This is what is happening so far and I'm so afraid the lack of f/u in Feb with my bariatric provider will affect my approval... I mentioned it at my follow up with the NP on March 11th but they acted like it wasn't anything to worry about and made it sound like it doesn't matter how close or far apart the appointments are as long as they're over the required amount of time set by my insurance. Is that right??

I marked which ones actually counted so hopefully it makes sense lol...

01/29/16 - Surgeon consult; Bariatric NP initial visit (#1)

02/29/16 - PCP for annual wellness (of course, weighed)

03/11/16 - f/u with Bariatric NP/labs/EKG (#2)

03/30/16 - Psych eval; Intial visit w/Nutritionist (3)

Am I on the right track? Will I be penalized for not meeting with my bariatric provider in Feb even though I had my annual visit with a recorded weight? He scheduled my follow up for 6 weeks after my first consult and I didn't think anything about it until after the fact...

I hope this makes sense lol. I've heard so many insurance horror stories that I'm just so nervous something is going to get messed up. Thank you in advance for any input!

- Keri

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Your Bariatric office staff should be well versed in your insurance company's requirements. I just followed what the office stated I need to go and everything went well.

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Same here. I just followed the guidance of the office. They have seen almost everything that could happen with insurance companies so they usually guide you down the right path.

As far as visits, the ones that were most important were mostly visits with my bariatric NP/Surgeon. The rest of it all had a general timeline that was provided by the office.

I'm sure you are right where you are supposed to be.

Sent from my iPhone using the BariatricPal App

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