Insurance Approval Experiences for CIGNA PPO?
Today I had my Psych evaluation. The DR said that everything is going smoothly and she doesn't see me having any issues with approval but did point out to me that sometimes Cigna Insurance is a pain in the ass. She made sure I called of course and asked for what I needed. I told her one of the things was I needed to have spent at least 12 months of trying to lose weight either under Doctor supervision or something like Weigh****chers.
I have been apart of weigh****chers for over a year. She suggested I get proof from them. Did anyone else have to ask WW for proof? Or would printing out billing info be enough?
Yes how did you pay? They also make a record every time you weigh in. I would say get all that from them because the more you have the better. I had MVP at one time who I think has connection to Cigna and they were a pain in the ass.
on 6/4/14 2:26 am
Every insurance is different. Even within the same insurance company, your specific plan's requirements may differ. The only way to be sure is to call the number on your card, give them your info, and get the exact requirements straight from the company yourself.
That being said, from what I've seen from many folks here... When a medically-supervised diet requirement is met by a commercial program like WW or Jenny Craig, billing statements aren't enough. After all, you could sign up and then ignore the plan completely! The insurance company often needs signed records of actual, physical, IN-PERSON weigh-ins from each and every consecutive month.
But call your insurance and get their word for certain, there's no way to tell otherwise.
Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!
Thanks all for the responses! I called my insurance AGAIN for a more detailed response.. other than 12 months of weight loss attempts and today she added 3 months documented.. And the trouble is.. that IT IS vague. SO all I can do is try to cover all my bases as best I can. I am having WW email me my weigh in records and billing info.
I have a progress appointment with the surgeon's nurse practitioner on Tuesday and I am going to ask her for her experience with getting enough proof- and if the the weigh in list and billing info will suffice and also if my time spent seeing the surgical office counts into the 3 months.
Gotta love insurance rules!
I have Cigna insurance and had to have three months documented visits also. At first I was told it was simply three consecutive months but when it got denied the first time we then found out that those three visits had to span a minimum of 89 days. I did not have to have documentation for my previous weight loss attempts, just the three months.
Thanks! Sorry you got denied the first time. That's what I'm afraid of! I'll bring this up with my progress appointment on Tuesday and make sure my time being evaluated with the surgeon has his 89 days... I'm sure it will since I won't be able to take my mandated "workshops" until July.