Question:
Does Cigna PPO require a referal from my PCP?

I have my 1st appt with my doctor on 9/4...I am trying to have everything ready to get the ball rolling...I have Cigna PPO and they did not give me many details on what information they would request from my doctor or me. And I found my WLS doctor through a friend and this web sight. Do most WLS doctors require a PCP referal as well?    — Jamie L. (posted on August 28, 2002)

August 28, 2002
I have Cigna PPO and no you do not have to have a referral from a pcp. This is what makes PPO so wonderful! Good luck! I just got approved recently myself and am now waiting for a surgery date. Feel free to contact me if you have any questions. God bless!
   — Rebekah A.

August 28, 2002
Technically Cigna PPO doesn't require a referral....but I would suggest letting your PCP know what you are planning. I did. Just so she would better be able to watch out for me and head off any complications she may see coming. I was surprised how easily Cigna PPO was to approve this surgery. Make sure you have all your ducks in a row before meeting with your surgeon. Once I had the consult, the surgeons office did everything with the insurance. The only problem I had was that the insurance company didn't seem to want to communicate with the surgeon. KEEP ON THEM!!! Finally, the right paper got from the insurance to the dr. The approval was the easy part!!!
   — Lucy T.

August 29, 2002
I am on PPO insurance as well. I discussed the WLS thing with my PCP before ever going to see a surgeon. She agreed to write a letter of medical necessity to the insurance company. I included this in the packet of information, along with another letter of medical necessity from my surgeon. In my case, I was out of network, so I felt that having a doctor who was part of the network validate that I needed the surgery was important. It is also my feeling that a letter from your PCP could possibly carry more weight with the insurance company than one from your surgeon. After all, this is the physician who oversees your health everytime you get a cold, need a blood test, have an ache or pain. I would get a letter from them. What could it hurt?
   — Greg P.