CIGNA!! Need advice!! HELP!!

Hello, I've been sailing along, getting this and that test and all I knew was Cigna was approving everything as these were all referrals via my surgeon Dr. Aranow. Okay...yesterday I received a letter telling me Cigna is not paying my $900 pysch evaluation because there was no approval or referral or somethign to that effect. Anyone else have this experience? Have I done something wrong? How can I rectify this? I can understand requiring a copay, but not the entire amount? Dear heaven, my next fear is all KINDS of bills coming in, with the same explanation. Oh dear!! My paperwork is in for approval so my fingers and toes are tightly crossed while I'm simultaneously becoming unraveled by this. again...HELP!! thank you, Cynthia

Hi Cynthia - I have Cigna as secondary to my Medicare. I just had my psych evaluation at St Raphael's for $80. What in god's name did you have to do for your test? My psychologist had me pay him direct and said he would send me the paperwork to send in to the insurance companies. I did not leave with a good impression of him. Can you imagine in 45 minutes he decided that he knew all about my personality flaws and told me we would have to work on them. Jeez, I wonder why my shrink I see once a month never mentioned I have a flawed personality. Sorry to carry on. Just that now i am obsessed by his comments. I need to call my shrink for validation. I read Cigna was a bear of an insurance company to deal with. I sometimes feel guilty because Medicare does not have to be submitted for approval. St Raph's is one of the Centers of Excellence. When I called Cigna they told me that if Medicare approves it, then they will too.

Hi Linda, So far, Cigna's been okay and has approved every test, including two in hospitals with anethesia..it's just that I've hit this bugaboo. My evaluation was a one on one interview that went on for over an hour and then I took a written test. It was certainly worth paying for, but I'm not sure it was $900 worth, not that I'd know what that would be. OTOH, the bill I saw from Cigna was what was submitted by Middlesex outpatient, not necessarily what it would cost out of pocket. Then again, I'm sure if I can't get Cigna to address this, $900 is what we're going to be negotiating. I'll tell you, in a way it was really worthwhile because until that interview I wasn't sure and not committed to a specific surgery. I had gone into my first surgical consult believing I wanted a lapband but my surgeon felt I would have a more successful result with RNY. So for months I was mulling this over, while taking a bunch of tests and never really felt committed to the process. But once I started talking about my deeper feelings about surgery, and pushing this around on another level with a professional, I KNEW I wanted the surgery very much and that I wanted a lapband and most importantly WHY I wanted it. I really didn't have a choice (I don't think) about who did my psych eval. I was referred by my surgeon and that's how I found her. Plus I did discuss with the office of the psychologist my insurance and what is covered and what isn't. So I'm kind of perplexed how this happened. I'm guessing this is a clerical problem but I don't know. Weds I'll call everyone and find out what's what. Or try to. I dont know if calling anyone is the way to go. But if I start with my surgeon, someone's going to know something. I'm sure this has happened to someone before with Dr. Aranow. We'll see. Anyway, thanks for your response. Have a great 4th!! Cynthia

Generally speaking with most insurers the psych is handled by a sub contracting company. Your approval for psych needs to go thru them- look on the back of your card and see if there is a mental health number different from the regular number. My psych wasn't paid for either- neither was my nutritionist visits. C'est la vie. If they pay for the surgery the $900 for the psych will seem like a drop in the bucket to you later on....