Calling out to the Guru/and anyone who has Cigna
My doctors office called in all of my paperwork to see if there is anything else I need. I provided them with everything requested of me. I have gone to two doctors in the last four years to assist me with weight loss. The most recent doctor I have seen for a year and a half. Towards the end, I would see him every two months. The nurse is telling me CIGNA said the two month intervals voided my six months. WTF? I have met everything else they required. On the coverage page it states:
Failure of medical management including evidence of active participation within the last two years in a weight management program that is supervised either by a physician or a registered dietitian for a minimum of six months without significant gaps.
Every two months is significant gaps? Is there anything I can do about this? It is imperative that I get all these things approved by August. I am unemployed at the moment and paying for Cobra. I will start a new job on the 20th but the insurance does not start until August. Their insurance is AETNA which I have not been reading any good things about. HELP!!!!
Failure of medical management including evidence of active participation within the last two years in a weight management program that is supervised either by a physician or a registered dietitian for a minimum of six months without significant gaps.
Every two months is significant gaps? Is there anything I can do about this? It is imperative that I get all these things approved by August. I am unemployed at the moment and paying for Cobra. I will start a new job on the 20th but the insurance does not start until August. Their insurance is AETNA which I have not been reading any good things about. HELP!!!!
I'm having a similar problem with Cigna. I had my first four appts consecutively. I went on vacation for 3 weeks from May-June and by the time I could get back into the doctor, I had over a 60 day gap. I was not told about this by my doctor until I called in to make appt 5, even though I told the receptionist that it would be more than 30 days before I would know when I could reschedule at my 4th appt. I found the same wording you posted above on CIGNA's site under bariatric weight loss requirements. When I called CIGNA, the lady I spoke to said I would have to start over because my appts had to be 6 months consecutively. I read the wording to her noting that the word "consecutively" does not appear. At that point, she stated that I would need to complete my 2 remaining appts then file for an appeal. She said to be sure and place a copy of the above wording with my appeal. Hope that helps.