Approval question?

you guys have been so awesome answering my question so wanted to say thanks and one has been on my mind.

When i first decided to have RNY , I called my insurance they said it is covered at 100% (cigna) so i filled out all paper work, sent it in to oregon weight loss and they sent me a letter saying it is indeed covered at 100% as long as I go to a center of excellenceas well as my PCP approving (she did) and see the surgeon once a month for six mos. ( I do meet all health criteria)  so Im scheduled for all related appts(ekg,bloodowrk,dietician, phycological eval, fitness test etc) this month and had my sleep study records sent over. then next month I start the monthly appts with surgeon. So my questions is would this mean I am approved for surgery if all this goes as planned. I wouldnt think my insurance would pay for all these expensive tests if they arent going to approve me. Any info would be great, thanks so much for being here.

Helen

I still think you need to go through the approval process ....I could be wrong maybe just a formality

In my case, and yours may vary, my INSURANCE approved me with fewer requirements than my SURGEON had. So yeah, according to them I didn't need the expensive tests, but without them, the surgeon would not have done the surgery so I did need the expensive tests.

And actually, I'm glad I had them. They gave me a great baseline to begin working from and identified a couple issues I would not have known about without them.

Just be certain that not just CIGNA covers your surgery, but your actual company provides benefits.  When i called my insurance company and entered all my information so i assumed they knew what my company covered.  So i went to the first appt and lo and behold my company does not have WLS benefits.  So yes, CIGNA does cover RNY but just be sure to check with your human resource dept that you have bariatric benefit.  IF not, you will have to fight really hard to get it covered.  I did....and won.

Good luck.

I have cigna mine was covered 100% You are not approved yet. You have to meet ALL of their requirements along with the requirements of your surgeon. One those all have been met, surgeons office will submit to Cigna Then you will heard if you are approved or denied.
I met all requirements and was still denied first submit. Cigna claimed surgeons office did not submit everything ( which they did) it went back and forth for a wee****il my surgeons office demanded a peer to peer with the cigna Dr. SUDDENLY I was magically approved on the spot.LOL
They play games they say denied hoping you give up and they save ALOT of money. Don't give up. If you first get denied.