XP: Got my Cigna Approval
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.
Feel free to PM with any questions. Hopefully I can offer back some of the help I've gotten on here.
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.
Feel free to PM with any questions. Hopefully I can offer back some of the help I've gotten on here.
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