, you must be proactive in following up for yourself. Start. "image": "https://s.bariatricpal.com/uploads/monthly_2017_12/S_member_3372.png", What is a PCP? // END Shopify Context //setInterval(function(){googletag.pubads().refresh();}, 75000); I have an appointment set with my doctor to get a letter of medical necessity and my insurance covers lap band. function viselyForumInit() { I am as healthy as can be but because of my height 5ft 1 inch and 196 lbs, I am 75 lbs overweight. I want to first give all thanks, praise and honor to God who has delivered me from my misery. ", I am praying that once all of my paperwork comes together, Cigna will approve it for me. Who knew? I meet the criteria, I\u0027ve completed what was required by Cigna, my policy covers Lapband (no exclusions). { Penguin733 Download BariatricPal for your iPhone, iPad or iPod Touch! She stated that they would mail a letter to me and the Dr's office. I typed a letter up for the Hospital in which will be performing my surger and I'll send it to you. I called back and Cigna said they could not give me the number over the phone but would mail it. var messageDate = new Date(); The Pre-approval Process - Obesity Action Coalition if (modifyClass === 'add'){ Once getting through the Rep in Pre-D pulled my chart and gave me the Authorization number over the phone. The 2 things that Cigna requires is a Psy Eval and diet program. }, Guess Cigna is hoping I\u0027ll go away but I\u0027m not!\n\nHang in there! \n \nWarmest Regards,\n", The doctor wraps a band around the upper part of the stomach to make the stomach smaller. "@type": "InteractionCounter", .visely-recommendation-item { background-color: #ffffff; margin: 7px; position: relative; display: inline-block; border-radius: 5px; box-shadow: 0 2px 2px rgba(11, 25, 28, 0.1); } They suggested my surgeron and their Director of Medicine talk about my case. I'm interested in knowing if you were denied, how long before you got that word, and if you were approved, how long for that? The Rep told me that she could not give me the information over the phone and I immediately asked for a Supervisor. Bariatric surgery proceduress covered by Cigna-HealthSpring PPO are: Gastric Stapling. Sign up for a new account in our community. Auto. How will your pregnancy be different after weight-loss surgery? "item": { I did not go on Weight-watchers, Jenny Craig, etc but I did do the, To say the least I was ecstatic! Some patients may be pre-approved for surgery within 12 weeks, others could take as long . } There are a few things I would like to share with you as you press forward. Although I had not been on a 6 months diet program, I did have 5 years of weight loss on file. Although I had not been on a 6 months diet program, I did have 5 years of weight loss on file. if (classModifiers[2]){ googletag.defineSlot('/15547294/BP_Sidebar_125x125_SQ2', [125, 125], 'div-gpt-ad-SQ2').addService(googletag.pubads()); .ipsLayout_sidebarright .most-popular .visely-pagination {visibility: hidden;} So now I just need to tell my regular doc and he will give me the letter. .cycle-3 img:nth-of-type(3) { -webkit-animation-delay: -9s; animation-delay: -9s; } The most important thing was getting the Authorization number even if we didn't have the letter yet. He then told that I would need me a series of tests prior to being qualified for the surgery. They suggested my surgeron and their Director of Medicine talk about my case. Make sure they have all the pieces they need to render a determination. }}, 500)); .visely-pagination button.small { margin: 0px 5px; padding: 5px; } My PCP type a very generic letter stating my weight loss, disciple, determination, etc. It's regular to find health insurance firms that willing not reward for weight-loss surgery. How long does it take for a person to get approved for weight loss surgery? cachedDevice = newDevice; googletag.pubads().refresh(); PCP stands for Primary Care Physician. function debounce(func, wait, immediate) { var timeout; return function() { var context = this, args = arguments; var later = function() { timeout = null; if (!immediate) func.apply(context, args); }; var callNow = immediate && !timeout; clearTimeout(timeout); timeout = setTimeout(later, wait); if (callNow) func.apply(context, args); }; }; I called back and told the Rep that we had not received the letter and due to time constraint I needed the information today! "dateCreated": "2007-06-20T03:43:47+0000", kacee, May 12, 2007 in Insurance & Financing. After giving me the run around she finally transferred me to the Pre - Determination department.The Representative from the Pre - D department then asked me to hold, she came back and said we have the paper work in office and you are approved! April 19th seems like too long ago for there to have been no response at all.\n", At least 20% of adults in every state are obese. useCompiledFiles: true, This is an excellent way to make sure that this procedure is covered under your contract. Another key is bypassing the first Representative and being transferred to another department who can give more concrete information. \"Cigna is tough and they usually require documentation stating the different diets, weight loss and/or weight gain with each diet\". .visely-recommendations-container .product__title p { margin:0px; } Any other out there with good/bad Cigna stories? in PRE-Operation Weight Loss Surgery Q&A, By When combined with lifestyle modification, endoscopic sleeve gastroplasty results in about . I hope that this note can be of help to the many who seek Lap Band Approval. Gastric Bypass. Cigna does cover the Psy Eval and everything else that you need! "logo": "https://r.bariatricpal.com/uploads/monthly_2018_10/logo.png.13014fc8659df17527ebe62b18103bd0.png", He said he would write me a letter of medical necessity if I went to a Cardiologist and was cleared. In most states the law calls for quick turnaround on requests for precertification; though 30 days is typically the max it shouldn't ever take nearly that long. He then asked me to call Cigna back to get them to fax a \"Authorization Letter\" which would have the Authorization number on it. "potentialAction": { "itemListElement": [ ips.setSetting( 'ipb_url_filter_option', jQuery.parseJSON('"none"') ); "@type": "Person", My paperwork was submitted April 19. @-webkit-keyframes fade3 { 0% {opacity: 0;} 5% {opacity: 1;} 35% {opacity: 1;} 40% {opacity: 0;} 100% {opacity: 0;} } .visely-pagination ul li { display: table-cell; white-space: nowrap; padding: 0px;} endoscopic sleeve gastroplasty can be converted to other bariatric surgery. "@type": "Comment", I'm sitting on 131.2 now, I'll be I the 120's next week or the week after! ips.setSetting( 'shopifyUrl', jQuery.parseJSON('"https:\/\/store.bariatricpal.com"') ); There are several tests such as an Upper G.I., Eco, Stress test & Psychological Evaluation. It\u0027s just crazy! MasonMoonGirl Once getting through the Rep in Pre-D pulled my chart and gave me the Authorization number over the phone. Your doctor\u0027s office is correct, denials usually come fast. In order to qualify for the Cigna weight loss surgery, you will need to meet the following Cigna bariatric surgery requirements 2019: You must be 18 years of age or older. }, The Rep told me I would receive a letter advising whether or not I was approved or denied. I bought my first pair of jeans in over a decade and am wearing them. googletag.defineSlot('/15547294/BP_Header_900x50_U1', [900, 50], 'div-gpt-ad-U1').addService(googletag.pubads()); Then I need to find a person to do the psych eval. // Bug fix: The resize event is triggered when tablets and mobiles are scrolled, breaking the search bar in Android and Chrome "text": "I have Cigna also and I was wondering if they tell you why you were denied? Medicare can take about four months to approve your bariatric surgery, but the timeframe depends on your health. There are several tests such as an Upper G.I., Eco, Stress test \u0026amp; Psychological Evaluation. "comment": [ kayhay0714, July 7 This change aligns with our existing medical coverage policy, Bariatric Surgery and Procedures - (0051). "mainEntityOfPage": "https://www.bariatricpal.com/topic/32268-cigna-people-how-long-did-it-take-for-approvaldenial/" "@type": "Person", ips.setSetting( 'emoji_shortcodes', jQuery.parseJSON('"1"') ); "url": "https://www.bariatricpal.com/topic/32268-cigna-people-how-long-did-it-take-for-approvaldenial/?do=findComment\u0026comment=461694", "dateCreated": "2007-05-16T16:58:29+0000", Then, you must call, call, and continue to call. Travel insurance requirements for surgery? .visely-pagination ul { width: 100%; display: table; table-layout: fixed; background-color: #e3e3e3; margin: 0; padding: 0; } In order to be approved by Cigna Health Insurance for bariatric surgery in the United States, you must meet the following criteria: The individual is at least 18 years of age OR has reached full expected skeletal growth AND has evidence of EITHER of the following: Diagnosis of Morbid obesity, defined as: A Body Mass Index (BMI) greater than 40 I'm ecstatic and can't wait until July 2nd which is my surgery date! I hope I didn't scare or discourage you! LOL any suggestions? Then, you must call, call, and continue to call. Bariatric Surgery Facts & FAQs l Sansum Clinic var ViselyIntegration = 'external'; }, God will deliver those who trust and believe in Him. Once I completed those test the Dr's office faxed the information to Cigna. Any other out there with good/bad Cigna stories? Auto. ] Cigna-HealthSpring PPO - Requirements For Weight Loss Surgery } I did not hear from Cigna so after about 5 days and I called the Dr's office to see if they had heard any news. "dateCreated": "2007-06-21T04:45:10+0000", "image": "https://s.bariatricpal.com/uploads/monthly_2017_12/M_member_7780.png", $(window).resize(debounce(function(){ var newDevice = detectDevice(); if(newDevice !== cachedDevice){ Ninjawoody "image": "https://s.bariatricpal.com/uploads/monthly_2017_12/K_member_15730.png", I did that and the heart is good. So far I have 2 more visits with the nutritionist and I am going to my regular doctor in July. Once I hit my plateau I applied for the Lap Band with Cigna. "@type": "Language", Go now! "datePublished": "2007-05-12T18:18:46+0000", "@type": "Person", @media only screen and (min-width: 768px) and (max-width: 1023px) {} Keep calling! "@type": "ListItem", I told her that I've never received anything that they said I would and demanded to speak with the department who makes the final decision. This approximately takes 1-2 weeks after the nutritional class. Overview General Information. Medicare patients' claims must be filed no later than the end of the calendar year following the year in which the services were provided. I figure the more doctors on my side, the better. "@context": "http://schema.org", I then told him that this is all I have so let\u0027s go with it. I\u0027m interested in knowing if you were denied, how long before you got that word, and if you were approved, how long for that? What I found out is you MUST submitt all the necessary paperwork at the same time to avoid getting denied. I said "praise GodI'm approved! "text": "I have CIGNA. googletag.defineSlot('/15547294/BP_Sidebar_125x125_SQ4', [125, 125], 'div-gpt-ad-SQ4').addService(googletag.pubads());googletag.defineSlot('/15547294/BP_Sidebar_300x250_S1', [300, 250], 'div-gpt-ad-S1').addService(googletag.pubads()); .cycle-2 img:nth-of-type(1) { -webkit-animation-delay: -3s; animation-delay: -3s; } var ViselyPage = 'index'; "url": "https://www.bariatricpal.com/topic/32268-cigna-people-how-long-did-it-take-for-approvaldenial/?do=findComment\u0026comment=436486", "@type": "ListItem", Only twice was I able to get past the first line of customer service reps (and I've been denied 3 times). I meet the criteria, I've completed what was required by Cigna, my policy covers Lapband (no exclusions). "addressRegion": null, "query-input": "required name=query", VSG on 12/19/12. $(targetElement).toggleClass(className); Seriously - when I called Cigna they couldn't explain it to me either! }, I have Cigna also and I was wondering if they tell you why you were denied? } that I had not received the letter and needed to know what information they were still needing. "image": "https://s.bariatricpal.com/uploads/monthly_2017_12/K_member_15730.png", var detectDevice = function(){ var grabPageWidth = $('body').css('min-width'); return parseFloat(grabPageWidth, 10); } "author": { Skilled developers utilize SharePoint's features, APIs, and tools like SharePoint Framework to build tailored solutions that enhance collaboration, data management, and business processes. }, He was never able to reach the Director of Medicine. I called them on Tuesday to confirm that they had received the fax and they did. { Very happy! Pregnancy After Bariatric Surgery | Cigna analyticsProvider: "ga", Patient safety is our highest priority. I also have Cigna and would love for more Cigna people to respond. Medicare Coverage for Bariatric Weight Loss Surgeries .visely-recommendations-container .product__prices { padding-bottom: 10px; } Just my guess. . She agreed that the Lap Band was one of the safest techniques out there so we moved forward. Hello All!!! "url": "https://www.bariatricpal.com/topic/32268-cigna-people-how-long-did-it-take-for-approvaldenial/?do=findComment\u0026comment=433635", "image": "https://s.bariatricpal.com/uploads/monthly_2017_12/S_member_3372.png", Search. This change is effective for claims with dates of service on or after January 15, 2021. Bariatric Multivitamins! She then asked me to find a Doctor who performs the procedure and do my re-search to check the credentials and success. "url": "https://www.bariatricpal.com/profile/15730-kacee/" The individual is at least 18 years of age or has reached full expected skeletal growth AND has evidence of EITHER of the following: A Body Mass Index (BMI) of 40 or greater. "mainEntityOfPage": "https://www.bariatricpal.com/topic/32268-cigna-people-how-long-did-it-take-for-approvaldenial/" } Good Luck! My surgeon called 4 times before he gave up. For example, some brand-name medications are very costly. Gastric bypass surgery: Gastric bypass and other weight-loss surgeries make changes to your digestive system to help you lose weight by limiting how much you can eat or by reducing the absorption of nutrients, or both. to see if the Insurance Company has contacted you. } "text": "My experience with Cigna Insurance and the Quest for Lap Band approval. My paperwork was submitted April 19. I was told to attend a Seminar to see what the Lap Band was all about, etc so I did. . So the Rep stated that they would send it to me and the Dr's office via "snail mail". How long did you wait for insurance approval and surgery date? So much was going against me but I stayed on my knees trusting in God. googletag.pubads().enableAsyncRendering(); "@type": "Person", If you get a rep that is not so helpful - hang up and call back. // http://osvaldas.info/drop-down-navigation-responsive-and-touch-friendly I am 10 days post op VSG surgery. She agreed that the Lap Band was one of the safest techniques out there so we moved forward. To say the least I was ecstatic! Verify Your Insurance Coverage What Are The Pre-Approval Requirements [] They say they have 14 business days to approve but my approval was done within 24 hours but the info did not get to me for 3 business days. Long-term care options in Medicare; Medicare benefits accessory benefits; Medicare advantage open enrollment; Home. "image": "https://s.bariatricpal.com/uploads/monthly_2017_12/B_member_18037.png", Does Medicare Cover Bariatric Surgery? | Medigap.com } And that time I actually talked to 4 people and no one could explain it! "name": "kacee", mapApiKey: '', Download BariatricPal for your Android Device. Frequently Asked Questions | Cigna Health Care Provider Directory What I found out is you MUST submitt all the necessary paperwork at the same time to avoid getting denied. Started 6 hours ago, By I typed a letter up for the Hospital in which will be performing my surger and I\u0027ll send it to you. They did not and the Receptionist encouraged me to call Cigna to see what status my paper work was in. "@type": "Comment", .cycle-3 img {-webkit-animation-duration: 9s; animation-duration: 9s; -webkit-animation-name: fade3; animation-name: fade3; } First, have all your ducks in a row before submitting paperwork to Cign or they will quickly deny you! It is annoying to continue calling but if you do not call over and over, your chances of getting approved is veryvery slim! Plans come with $0 virtual care and $0 preventive care. PDF Bariatric Surgery and Procedures - Cigna I did not loose any weight the last 2 1/2 years and that is why I began to see medical help. "dateCreated": "2007-06-21T02:06:35+0000", { Hopefully I am not asking too many questions.\n", Cigna said they needed more information but refused to tell me what information they needed over the phone. "url": "https://www.bariatricpal.com/profile/18037-bfynentyme/" .visely-recommendation-item .product__image img:nth-of-type(1) {display:block; position:relative; top:0 !important; }
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