Got my approval from Cigna!!

Sam I Am
on 9/25/08 10:27 am - Raleigh, NC
and a surgery date of 10/30 from Duke WLS.

I'll post this in my bio too, but here's my brief summary.

Starting thinking about WLS in November 07, when I looked into it I realized it was an exclusion on the United Healthcare policy provided to me by my employer.   When open enrollment came I got on my Husband's plan with Cigna.  I began my six months monitored diet and weight loss in January 2008.  I went to a seminar at Durham Regional on January 11th.  I got all my applications materials into Duke in mid February and my first appointment was May 21st.  I went to my first apointment with Duke, I had my psych eval and meeting with the RN.  The nutritionist was out that day so he reviewed my records and sent me something later.  I continued going to my Primary Doctor once a month every month.  We did a low fat/low calorie diet with increased exercise and I tried Meridia for three months, but stopped because it was causing anxiety. 

I requested and received five years of medical records documenting a BMI over 40 (though I don't believe this is a Cigna requirement).  I had an EKG, a Barium Swallow and blood tests. All of my tests were normal and I have no co-morbid conditions, but my current BMI is 54.

I sent all my medical records to Duke on August 11th.  I was submitted to insurance on September 17th.  UHC gave me a problem and would not give me a letter in writing stating that WLS was an exclusion on their policy.  (They also told me they did not have a fax machine).  They said the only thing in writing they would give me would be a denial EOB after I had the surgery and submitted it to insurance.  They have still refused to send something in writing, but we submitted to Cigna with a copy of the plan documents.

It was submitted to Cigna on 9/22.  They initially decided to deny it on 9/25 stating that I did not have a nutritional eval.  Duke forgot to send it with the intial eval, I called Debra and she faxed it right over.  I called Cigna again and they said to expect a decision next week.  Debra from Duke called me at 4:15 on 9/25 (today) and told me that Cigna had called and approved it.  I called CIgna to confirm because it seemed too good to be true.

I had heard horrible things on here about Cigna and was really worried about insurance approval, I must say the process was very easy and everyone I talked to at Cigna was very helpful.  I have heard things about Duke being very slow and it did take a while to get my first appointment.   However, from the time they got my medical records until the time I was submitted to insurance was only a little over a month.  Everyone I have talked to over there has been very polite and helpful.  My approval from Cigna may have come faster because I called a lot.  I was always polite with them though. 

Anyway, that's my story.  I hope it helps someone who is reading all the bad stuff on here about Cigna.
kilmarlic
on 9/25/08 11:06 am - powells point, NC
Congratulations -------------I had CIGNA too and it took them over a month to get me my approval. My file had ended up in the wrong department. Everyone I spoke with at CIGNA was really really helpful. I'm so glad it went smoothly for you.

- Iris

Blessed are the flexible for they shall not be bent out of shape.

Highest      Surgery    Lowest      Current                                                                 

 314.5          294          208        258.4

cindylou44
on 9/25/08 12:10 pm - Winnabow, NC
Congrats on your upcoming surgery!

Cindy
Band to DS
on 9/25/08 12:11 pm, edited 2/1/12 11:25 pm
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

Barbara C.
on 9/25/08 1:17 pm - Raleigh, NC

Sam,

Congratulations on your approval. I look forward to your upcoming surgery.

I'm glad that everything has gone well for you.

All the best and continued success,

Barb

Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145

shaunab68
on 9/25/08 1:28 pm - Black Mountain, NC
Congratulations!  I bet you are so excited to have an actual surgery date.  Here's hoping that the next month flies by for you! 
Alice H.
on 9/25/08 10:17 pm - Winterville, NC
Congrats!  Time for a happy dance........  Alice
Alice in OneDerland
H:260 G: 135 
C:145 L: 131 BMI: 26 H: 5' 2 1/2" 
RNY 10/07  LBL 11/09
Rahsheeda80
on 9/25/08 10:18 pm - Greensboro, NC
Congrats, that is awesome.  The date will be here before you know it.

Rahsheeda



Highest 268/ Current 160/ Dr. Goal 130/ My Goal 125/ Height 4'11"Photobucket

Donna B.
on 9/26/08 11:30 am - Somewhere in, VA
Congratulations!!  Hope the next month flies by for you. 

    Life is short ~ dance like no one's watching!!

305/292/167/159
High/Surg/Curr/Goal

CindyNNC
on 9/28/08 9:45 am - Albemarle, NC
Congrats! Oct 30th is my daughters birthday, so that will be a great day for you!
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