Cigna Approval in GA

[Mimiwumba 1]

Good morning! New here just starting the process of getting approved by Cigna on a OA plan in Georgia for the Gastric Sleeve. I have been working with a Nutritionist and exercise coach since November. However I missed an appointment in December because I came down with Pneumonia. My surgeon's office says that CIgna requires 6 months of nutrition and exercise for pre approval. However when I called Cigna they told me once they did require 6 months then the next time I talked to them they said they didn't. They seemed VERY confused on what is and is not required. Is there anyone in GA with Cigna that has been through this process? Do you know if the 6 months is required and if they must be consecutive? Also I would love to chat with anyone on their experiences with Kennestone and Dr Fritz Jean-Pierre. I am hoping for a surgery date in May 2020!

[GradyCat 3,697]

Generally, for most insurance companies who require it, it is six consecutive months and if you miss a visit in a month, you start all over again.

[Puffy-no-more 141]

I do not have that insurance but my insurance company was the same way. One person said they required it, the next said they didn't. I finally pulled up the policy online and found they had revised the requirements on what was mandatory the month prior. When I called them back and quoted the policy to them, they said that information had not reached their office yet but that it was "probably" accurate. So my doctor's office decided to send in a prior authorization just to see what they would say. It got approved in 4 days.

I said all that to say that maybe you should just try the prior authorization. My surgeon's office said that if it gets denied, they will send specific requirements that you need and thAt will be the most accurate information you will be able to get on it because it's not coming from a customer representative but rather someone who actually approves or denies based on the info.

Good luck!