Cigna PPO

Has anyone dealt with Cigna Prefered One PPO? I have not heard very many positive things aout dealing with them. Any information would be really helpful.

Cigna in general is one evil insurance company when it comes to this surgery. They're pretty strict with their requirements, and the 26-week-diet seems to be the biggest hurdle for most of us (i got lucky there). Here's the general requirements. Dont submit anything to them and expect to be approved unless the following is included: 1 or 2 26-week professionally supervised diets with monthly weigh ins. You can use Weigh****chers if you have the weigh in card. The diet(s) have to have been within the past 12 months. (most plans require 2 of these diets, one within 12 months. My plan only requires 1) Psychological Evaluation and Clearance. Go find a psychiatrist if you don't have one. You'll need to take the MMPI-2 test (570 question test) as well as have a nice talk with the psychiatrist, who then will write you a nice letter stating that you're not nuts. Nutritional Evaluation. Meet with a dietitian/nutritionist for an evaluation. They must also write you a letter that states that you understand what life will be like after surgery. (email me for more info). Medical Evaluation/Clearance: Your Primary Care physician has to write you a letter. Make sure it's in depth and states your co-morbs and the treatment you've seeked for them. Make sure he puts any and all diet attempts noted in your chart into the letter. Make sure the doctor states that this is a medical necessity and that you are cleared for surgery. Copies of your medical records for at least the past three years will also be something you want to include. I'm sent in my first appeal yesterday. It was 80 pages. Email me if you need some help with what to send in. Good luck April

Don't give up!!! I just won my 2nd-level appeal yesterday...So keep fighting...

Cigna can be beat! I had the surgery four days ago and getting Cigna to approve was more difficult than getting my doctorate. But, it can be done. The other responders are right on tract. DON' T GIVE UP! Write down what your weight was for each of six months with weigh-in dates (make it up!) If your PCP has already written you a letter of medical necessity there is a strong liklihood that he/she will varify that you were on this medically supervised diet. Get copies, off of this site, of other successful letters and modify it to fit you. Save it on a disc and give it to your doctor as an example of exactly what your letter of necessity must say. My doctor used the letter exactly as I wrote it and his secretary appreciated the fact that all she had to do was print it on his stationary. I was approved within two hours after faxing it to IntraCorp. Save everything as you can be certain that Cigna will throw away most of what you send them. Call every day. Understand that Cigna has farmed out all surgery decisions to IntraCorp. Call them and ask for your "TC" number. Get the names of everyone you speak to and take good notes. Call 1-800 253-6647 and ask if you have been assigned to a medical case manager. This person will help you. The Intracorp people are professional health professionals that want to be certain that you have all your ducks in a row to insure that you are not making a rash decision. These people can help you. Please let me know how you make out as I have other numbers that you may find out useful. It took me six months to get approved but I had to do all the work myself. It can be done so make the call. And, please, get back to me. Jim Egan Lap-Band completed 9/18/03 Dr. Nusbaum, New Jersey