Getting Started

 So I am understanding that I need to meet with my Dr. for  6months for a diet plan and 6 months of support groups? As soon as my insurance takes effect will I then contact the insurance company to see what I need to do?

Yes.  You need 6 months of a physician's supevised diet. This means you need to go to the doctor 1x a month for 6 consecutive months. He needs to record your height, weight, bmi, what type of diet you're doing, and what type of exercise you're doing.

There is no certain weight you have to lose on the diet per Cigna, but your wls surgeon may have a goal for you to reach to make the surgery safer.



The support meetings can be anywhere as long as it is a wls support group.  When I did mine they were not at a Center of Excellence. (This may have changed).


Go ahead and get these 2 tasks out of the way because they take the longest. You can start today.


You also need to be attending seminars and picking out a surgeon, since each surgeon has their own set of tests they'll want you to do in addition to cigna's requirements.


In January call Cigna and let them know you will be having surgery. Ask to be assigned to a case manager.  They don't automatically offer this, but will do it if you ask.

You will need to complete the online health assessment,  and have a psych eval and meet w/ a nutritionist
.
These are really just a formality. I have never heard of anyone not passing it.

I am trying to get the cigna guidelines of the website, but it is down right now.  I'll post it when I can get it.

If you go ahead and start this month, you should be ready for your surgery late March or early April.

The requirement list came out a little weird, To access it directly from Cigna. Please follow these steps:




1. Go to http://www.cigna.com/sites/stateofga/index.html  <---- click here


2. Under the green Welcome SHBP Members. click on the blue   
                  Resources for Active Employees

3.  The 6th selection on the list is  {A } Bariatric Surgery (PDF). Click on this.





These are the official Cigna shbp  requirements for you to get your surgery.
Print it out and take it to your consult appt with your surgeon and give a copy to your pcp at your 1st diet visit.

As long as you do everything on the list you should have no problems getting your surgery approved.

It really depends on your Ins. plan.  Some of my patients with CIGNA only have to do 3 months, but they see the psychologist, dietitian and PCP every month for 3 months.  Check with your insurance company this may be an option for you.

Take care,

Ginger

State of Ga employees don't follow the regular Cigna requirements, They have added additional requirements for us..So 6 months of everything.   I posted a list to the State Employee Cigna requirements.   Make sure your office is following this list for state employees.

We have all patients check with their individual insurance companies to make sure all hoops are jumped through.  People can have the same insurance company but be under a different plan with different requirements.

Have a good day.

Ginger