Cigna Insurance questions

YAY you! you have it scheduled :) 

I have Cigna OAP, they required 4 total nutrition counseling visits. The first was with a nutritionist in my surgeon's office, then I did the next three, approx 30 days apart (90 days) with my PCP.

At each of these, they took my vitals, doc and I discussed my weight and what I was eating, he told me to exercise, we laughed and he said he'd see me in 30 days. It's all about the billing codes they use.

Have you spoken with a surgeon yet? Mine walked me through the whole thing, which is why I went with that surgeon. Cheaper out of pocket for me than the others in my area, but they had a patient advocate, nutritionist, psychologist, cardio, etc - all on site. When my PCP needed direction, the surgeon's office gave it to them.

Yes I have spoken with the surgeon and his "crew" I have OA In-network ... There was a nutrition requirement, but just 1 visit. I do have to see my PCP for at least 90 days..Each visit we talk about my weight, the low carb diet and exercise I'm trying to do.

The Surgeon's office did tell me that is was VERY important to have the PCP right a RECOMMENDATION letter not a referral letter...I"m scheduled to see my PCP next week and I hope to have his recommendation letter. I'm going to see about making an appointment with the surgeon's insurance person so I can make sure he has all the necessary paper work. 

Hey Monet,

I was thinking about you.  Have you heard from Cigna yet? 

Petetrox, YES they sent me a DENIED letter....come to find out that my employer does NOT cover the surgery no matter what...however, back in March the doctors office called the insurance company to see if it was covered under "medically necessary" and they told her YES...so I have called Cigna for a "misquote" review. They will be checking on that phone conversation to hear what transpired and if the insurance company did say YES it was covered then they have to HONOR the agreement no matter what my employer says about it...because the insurance company never should have told us that it WAS covered. I have spend MONEY for the last 3 mos, seen doctors and had lots of test and cigna covered all those...

SO Monday I will be calling the insurance company AGAIN to see if thy have listen to the phone message to see if there was a misquote....I am assuming they will say it NEVER happened...so I will request to hear it as well, because my doc office (during that same call) got all the requirements and deductible from the insurance company...

So please keep your fingers crossed, say a prayer, send good vibes...I"m hoping for a good turn out for myself. The doctor's office is still having me go through the pre-ob which is July 11th...Surgery is still scheduled for July 25th, I HOPE!!!

When is your surgery?