Question:
With insurance I have Cigna.

What is the difference between predetermination and prior-authorization?    — kylyn (posted on March 25, 2008)


March 25, 2008
i have cigna as well. the dr office should know the difference but i think pre-determination is them deciding and determining the surgery should be done. pre-authorization is when you get the final "go ahead". you can always call cigna and ask the insurence company. good luck.
   — JACKIESMOM

March 25, 2008
i have cigna as well. the dr office should know the difference but i think pre-determination is them deciding and determining the surgery should be done. pre-authorization is when you get the final "go ahead". you can always call cigna and ask the insurence company. good luck.
   — JACKIESMOM

March 25, 2008
Just make sure that your Doctor has got approval and so hasthe hospital. I left it up to the hospital and they did not get approval, but I still had to pay them over $25000.00, because the Insurance declined me. The letter came the day after I had surgery, and they would not revers it. It was UHC not Cigna. Just see it in writting and you are safe.
   — William (Bill) wmil

March 25, 2008
Predetermination is to make sure the service meets medical criteria and that the service is payable and a benefit. Pre-authorization is approval for the actual service.
   — tlsdc1972

March 25, 2008
HELLO I TO HAVE CIGNA. I LIVE IN PORTLAND OREGON MY HUSBAND WORKS FOR FREIGHTLINER. THIS IS VERY INPORTEN. I WENT THROW GOOD SAM HOSPITAL AND JAY,JAN WAS MY DOCTOR. CIGNA MAKES YOU DO 6 MONTH OF WEIGHT MANAGMENT BUT WHAT THEY DON'T TELL YOU IS DURING THE 6 MONTH YOU HAVE TO HAVE YOUR WEIGHT,BP,P,TEMP ALL YOUR VITALS DONE EVERY MONTH OR YOU WILL BE TURNED DOWN... YOU ALSO MUST TRY DIET PILLS APPOVED BY FDA FOR THE 6 MONTH YOU CAN NOT MISS ANY APPT. YOU ALSO HAVE TO HAVE YOUR WEIGHT DONE EVERY MONTH AND SEE A PHYCICAL THERPIST. IF YOU DON'T FOLLOW THIS THEN THEY WILL TURN YOU DOWN i WAS TURNED DOWN 4 TIMES I HAD TO CALL A HEARING. IT SUCKED AND WAS VERY STRESSED OUT. GOOD LUCK.
   — aluvzu2




Click Here to Return
×