Cigna insurance question--supervised diet
Lecaste
Posts: 13 Member
Hi all--
I'm on the path to gastric sleeve in September or October. I say or because it depends on when Cigna accepts that I began the 90-day diet requirement!
Long story short, I went to a clinical dietician on 6/16 and she worked out a detailed diet plan for me. Saw my PCP on 7/17 and we decided that sleeve surgery was the right choice gor me. I decided not to return to the dietician but just continue her plan with supervision under my PCP since PCP is at the same hospital I'll use for surgery and that's so much easier for record-keeping and appointment-making.
So will Cigna count my start as 6/16, when I began the dietician plan? Or did I restart the supervision clock by switching to my PCP? My PCP visit was 7/17, almost exactly a month to the day, so there were no gaps. I'll see my PCP on 8/15 and 9/15 too. And 10/15, as well I guess, if it comes to that.
In my mind, it's fine. I told the dietician what I was doing and she's good with it. But you never know with insurance hoops! I will ask Cigna, too, just wondering if others had some insight. I'd love to be finished in September!
I'm on the path to gastric sleeve in September or October. I say or because it depends on when Cigna accepts that I began the 90-day diet requirement!
Long story short, I went to a clinical dietician on 6/16 and she worked out a detailed diet plan for me. Saw my PCP on 7/17 and we decided that sleeve surgery was the right choice gor me. I decided not to return to the dietician but just continue her plan with supervision under my PCP since PCP is at the same hospital I'll use for surgery and that's so much easier for record-keeping and appointment-making.
So will Cigna count my start as 6/16, when I began the dietician plan? Or did I restart the supervision clock by switching to my PCP? My PCP visit was 7/17, almost exactly a month to the day, so there were no gaps. I'll see my PCP on 8/15 and 9/15 too. And 10/15, as well I guess, if it comes to that.
In my mind, it's fine. I told the dietician what I was doing and she's good with it. But you never know with insurance hoops! I will ask Cigna, too, just wondering if others had some insight. I'd love to be finished in September!
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I have Cigna too. I had to meet with my doctor 3 times and the nutritionist 3 times. It actually took less than 3 months because the visits were spaced at least 28 days apart. So, if you had a doc visit 7/17 that started your diet, then one on 8/17 and then 9/17 I think you will be fine. That's what mine looked like except I had nutritionist visits in there too, each 2 weeks before the doctor visits. Make sure you have all of your other things checked off for Cigna - the medical history, psyc eval, etc. They approved me quickly after my doctor submitted. Do you have your doctor for surgery selected? I did all of my stuff through them, because they knew exactly what had to be submitted in order to get approval.0
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Hi and thanks for the reply! Yes, I start with the surgical requirements on the 18th. They set up the nutritionist, psych, and other stuff. I'm getting it done at University of Colorado Hospital, so it'll be one of their two surgeons. They're a Center of Excellence and a leader in the region, so I feel I'm in good hands!
My insurance requires 90 days, so that ends up being 4 appointments, I think? 6/16, 7/17, 8/15 and 9/15. It's like 93 days between 6/16-9/15, according to an online date calculator I found. My biggest concern is them potentially squawking about me starting the diet process with the dietician but finishing with my PCP. Wouldn't think it'd be a problem, no gap in actual supervision for the entire 90 days, but I'd hate to get denied on a technicality!
Have you already been sleeved? How are you doing?0 -
I've got Cigna too, and I'm about half-way through the nutritionist visits. Based on conversations with her, it sounds like she writes a monthly report that she turns over to the bariatric group I am seeing. They pull her reports together with all of the other stuff I get them (psyc eval, PCP clearance, cardiologist, etc...) and send it in to Cigna. You may want to circle back with your PCP and see if they can get your nutritionists original report and use that to start the 90-day clock.
Heather, once you got your approval, how far out was your surgical date from that? I finish with my 90-days at the very end of September. Trying to see what a reasonable expectation is.
-Phill
Question- Why is the first spell-check suggestion for BARIATRIC BARBARIC???????0 -
Bwahaha @ the autocorrect switcheroo!
Agreed, Phill! I think including the dietician's notes should suffice. I have a copy of the plan, too. I see my PCP this Friday, so I'll make sure we're on the same page with that.
I was wondering about the date, as well. I'm doing the surgeon stuff concurrent with the supervised diet. They don't have a lot of requirements beyond the psych and nutrition visits. And even if they wanted heart, lung, blood or other tests I have them already since I have to get them regularly as part of the monitoring for my autoimmune conditions. Last sightseeing tour of my major organs was May. LOL
So I wonder if they'll give a tentative date as soon as the requirements are finished or if they wait until Cigna approves to give the date. PCP sees me as a very straightforward case and anticipates approval. And I heard that Cigna is speedy with its decision once all the documentation is in!
How ya feeling today, Heather?0 -
I had my surgery scheduled before I finished the supervised diet, only because I was on a tight schedule because of my summer teaching schedule so they penciled me in, assuming I got approval. I did all of the other requirements during that time as well - blood work, etc. My last appt was 6/27 and I had surgery on 7/29, so about a month later.0
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I like that, "last sight seeing of my major organs". I don't have anything auto-immune going on, but I've managed to collect a pulmonologist for my sleep apnea, orthopedic specialist for my ankles, cardiologist, therapist, and now nutritionist. So we're doing it all at the same time as well.
My husband is going for surgery sometime after me too. We're trying to figure out timing. We are both going to take 4 weeks off from work, so we can get our hands around our new routines. We are hoping to get his surgery scheduled 3 weeks after mine, so I;m still out while he needs the most help. He wants to schedule his at the end of November or beginning of December so he has as much of December off as possible. So that would put me around the first week of November, give or take. I figure that if they go for approval the first of October I should be able to get into a surgery date that fits that.0 -
Sounds like a great plan, Phill and how nice that you two will have a built-in buddy for the sleeve journey! I'm going to ask the surgeon if I can fly standby. :-P I'm ready to go like yesterday--finally see some light at the end of the tunnel and the very idea that my joints will get some much-needed relief soon is enough to make me smile.
Good luck!0 -
Oh and speaking of autocorrect...my internal version, AKA my brain, keeps making me think your screen name is "poppycock"!! Apparently, I'm 12.0
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Yeah, I get poppycock a lot, lol.
You mentioned you were in Colorado. What part? I grew up in the Springs. Nasty weather down south of them yesterday.
-Phill0 -
I'm in Denver!0
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An update for others who may have a similar question--the insurance coordinator said that as long as there are no gaps in supervision, there's no issue with switching who's doing the supervising. Great news!
I'm done with everything except the nutrition class on the 10th and the final supervision check-in on the 15th. Judging by whern they're scheduling now, looks like I may be able to get my surgery by Halloween. Fingers crossed!0 -
That;s awesome! We are going for our endoscopies next Wednesday. I have an Echo cardiogram and a nuclear stress test in September. They'll submit for insurance approval October 1. I'm also hoping for a date around Halloween., with hubby following a few weeks later.0
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Exciting! Halloween will be here before we know it!0
