Any recent success with cigna approval?

I know Cigna has recently made changes to their requirements.  they added a BMI of 35 with Cormorbs or Bmi of 40 with none for 24 months.  They did this in May 08.  I am submitting my paperwork to my surgeon today including a letter from my pcp stating my bmi and comorbs for 24 months.  Anyone submit to Cigna open access or the like lately?  Any bits of info I should know.  This is my second go around with my 6 mo diet.  I think I have everything in order now.  Any info is appreciated.

I too have recently submitted mine for the 3rd time. Each time I call they say they have not recieved. Even after registered mail. I have met the requirements down to the last word. This is driving me crazy. Any info is appreciated.

I have Cigna Open Access Plus (through Alcoa) and was denied on the first round.

They held the authorization as pending for a couple of weeks and then said that the doctor's office didn't send in my 6 month diet, nutritionist information, and the recommendation letter from my PCP -- which they did.

Once they received information again, they still denied it, saying it wasn't "medically necessary".  My doctor then contacted the medical director who decides whether it's medically necessary or not... did a peer-to-peer review... and in a matter of days, the denial was overturned.

Cigna does not seem to have it together with their computer systems. If the doctor's office faxes the paperwork to the main authorizations department, there are several channels the file has to go through before it even makes it to the Health Services department.

My advice after your paperwork is sent in?  Call every day. 

Write down the date, the time, the person's name you talk to... and get a status update.  As I was told by one of the representatives at Cigna (a very nice one that I never managed to get again), they work faster when the patient is calling and pestering them. 

I sure as heck did.  Called every single day.  Sometimes twice.  My doctor's office submitted my paperwork on 08/16/08...was denied on 09/02/08...and approved via appeal 09/08/08.

All of this might be things you already know, but anyway, I wish you good luck!!

I spoke with the surgeons office yesterday and was given a date for my consult.  The patient advocate said that I have more than enough documentation and all the required paperwork.  She said her experience is that as long as you have it all together Cigna has not been an issue.  I asked because I heard these stories.  I did my 6 mo diet before but the surgeons office refuses to submit to the ins until everything is in order and they feel there will be no denial.  Maybe this is now good news for others.  Have everything in order the first time.  I had to do the 6 mo diet 2x to get it right. 

Lynn76 do u have a date now?

My sister used to work in medical billing and said that Cigna was notorious for coming back and denying claims because they said something was missing in the file (that was there) or that a patient's name was misspelled... little things.  Anything to not pay it on the first time around.  She said that they never changed anything with Cigna submissions, just resent everything in the file.  Cigna always paid on the 2nd round...

That's great that you have a date for your consult.  I've tried for this surgery off and on for 8 years and finally did everything right this time :)

I have a date -- Sept. 25th -- but my problem now is that my doctor's office is requiring $3000 for a deposit on what the insurance won't pay.  I have no idea how I'll be able to round that up by Monday... Tuesday, at the latest.  I certainly don't want to have to do any rescheduling.  I'm scared something will happen and the insurance will change their minds!

Wow! 3k??  Makes you feel like your a cash patient.  I called Cigna 2x and both times I was told my max would be the max out of pocket deductible which is $1500.  However, I have already used part of that.  So now I will only have to pay $821.  I hope that is correct because I am having a hard time with that.  The 25th is so close.  How far out did they schedule you?

*nods*  It really does!  I'd hoped my MIL would help out until I could pay her back in two months, but she doesn't agree with the surgery, so won't help.  I've got a matter of like 3 days to have the money in, so I'm really hoping my 4wheeler sells on Craigslist :)

My doctor is out of network, so I'm being forced to pay a little more out of pocket. Unfortunately, I can't just switch physicians without going through another approval process and I'm too scared to try it.  Personally, I think they should give me some sort of break since I'm in a "network unavailable" area.

Not very far out.  It was the 16th when I found out I was approved and she gave me 2 dates... the 25th and October 2nd.  The "elgible dates" on my approval letter from Cigna gave roughly 30 days to have the procedure done... Between Sept. 8th and October 10th.

Not sure what happens if I can't get the funds together....

Yes, I got approved in 4 days, see my post above.

i was just denied for the 3rd time with Cigna.  They too tell me that they didn't get this or that and it's like a run around.  i would love to call everyday but I have no one name to call I just have to keep calling the customer service line and they call someone and come back on and say something ridiculously untrue.  now I was cited for not having the 24 month at BMI over 40 paperwork and my doc's office faxed it over so I am waiting again for the 4th time.

I was given a number for the authorizations department.  The person I first spoke to when I called customer service gave it to me.  It is at work so I will PM it to you tomorrow.