Insurance Process Question -- re Case Worker

I understand when you ask for approval from the insurance company that you can request a case worker. Do you request the case worker before the surgeon asks for approval or after the approval request is sent. I'm with CIGNA and so far they have paid every bill, including surgeon's consultation. I am having my last consult with the surgeon on 7/25 before the paperwork will be submitted for approval. Just want to have "my ducks in a row". Thanks.

Nile, I have Aetna and although there is a case manager they will only talk to my doctors office. I left a message and asked them to call me and found out they called when I was not home and did not leave a message. After a lot of phone calls I never have been able to talk to the case manager. I finally just faxed what I wanted them to know. Can I ask what paperwork you got together to send in or rather for your doctor to send in? Did you already check with Cigna to see what they require which may or may not include a five year diet history, family doctor letter, six month diet (could be more or less) etc., Just wondering. Jim