SHBP Cigna?
I found this accidentally by scanning the website. This is from the website:
CIGNA Criteria
For providers to participate in the weight loss surgery program, they must:
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Approval by the American College of Surgeons.
Maintain current Full Approval by the Surgical Review Corporation and/or Level 1 Full��
procedures performed at applicant facility during the most recent 12 month period:
Meet CIGNA clinical outcome metric thresholds for bariatric open and laparoscopic��
Overall mortality rate of < 1%��
Re-operation rate within 30 days of initial bariatric open surgery of < 2.5%��
subphrenic abscess, splenic injury, pulmonary embolism or wound infection of < 5%
Overall readmission within 30 days post initial bariatric surgery for anastomotic leak,��
Designation (including outcome metrics) annually.
Submit to CIGNA a completed Application to Receive Certified Facility for Bariatric Surgery��
Facility must be a participating provider with CIGNA.��
Weight loss surgery program must have at least one CIGNA participating surgeon.Telephone Communication
Once you»ve decided on surgery, you»ll be contacted by phone to educate you on:
�� What constitutes a comprehensive weight loss surgery program and of the importance tofully participate in the program.
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The need for lifetime changes in eating and exercise patterns and that a lifetime of followupis necessary.��
The danger of smoking, especially given your condition.First post-operative outreach to educate you on:
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The importance of controlling co-morbid conditions.��
Special dietary requirements and of the importance of following your doctor»s or nutritionist»s dietary recommendations.��
On signs and symptoms of complications of surgery and when to call your doctor.Subsequent post operative outreach to help you:
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Focus on co-morbidity management.
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Participate in weight loss surgery programming, including counseling, at the hospital.��
Assess complications of surgery and remind you when to call your doctor.��
body appearance.
Assess emotional challenges associated with all of the lifestyle changes and changes inFollow-up for complications
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Develop a care plan to educate and support you.��
Educate you on when to contact your doctor.��
Remind you that you can call the nurse after the case is closed.If you are denied surgery
If you do not meet surgery guidelines or your plan doesn»t cover weight loss surgery, we will offer the
following support:
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Education on value of using Bariatric Certified Facilities.��
Assistance with nutrition referrals for weight management.��
Help with make goals to meet criteria for surgery if appropriate.��
Focus on management of co-morbidities.��
associated with co-morbidities.
Instruction of how weight loss of as little as 5% can have significant impact on risks��
While extensive data on typical surgical complication rates is presently not available, the low
complication rates sought by our weight-loss surgery program are widely considered to be very good.
A recent study in October 19
that complications from weight loss surgery are higher than previously thought.
Health Rewards Amenities for weight loss.th 2005 edition of JAMA (Journal of America Medical Association) noted41
National Center for Health Statistics, 1999-20002
Surgeon General, Obesity in America, National Health Policy Forum, July 20033
Centers for Disease Control Study, 20044
JAMA, October 19, 2005, David R. Flum et al.Early Mortality Among Medicare Beneficiaries Undergoing Bariatric Surgical Procedures
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I 
MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
I only browsed thru the stuff you copied in your email but it looks like if you are denied, they are supposed to help you with other things. I've been denied and was contacted by a case manager to tell me of the denial. All she did was tell me what I was missing. But i got no referrals for "nutrition for weight management" or focus on "management of co-morbidities" etc... Very interesting!
Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
2 clik on my health tap on upper right corner
3 scroll down to condition and wellness resources
4 scroll down to weight
5 click on weight loss surgery program info
Nobody at Cigna had a clue what this is. I was told it does not exist!
Let me know if you find out how to get somebody to call you
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
