First Appeal For Panni - Help?

[emb5126 0]

Hello All!

I just received my first denial from Cigna for a panniculectomy. They didn't deny that it was medically necessary, just that it wasn't covered by my plan. I spoke to a fantastic rep with Cigna that urged me to appeal the decision but couldn't go into much detail about what they would want to see in the appeal. I vaguely remeber appealing for my band but it was 4 years ago and can't remember exactly what I did. The plastic's office won't help - apparently once they see there's a chance they aren't getting paid, they put their hands up. They won't even give me some tips of what the insurance company would want to see. I'm going to resubmit with the original documentation from the plastic's office, the lapband surgeon's notes and the photos along with more photos and a letter from my pcp. Is there anything anyone else has done to push that appeal through? Any tips or documentation I should include? I skimmed through other postings similar to mine and noticed that some members were offering sample appeal letters - does anyone have a copy I could check out?

Any and all help would be greatly appreciated!

Thanks,

-Emily

[nicholet 2]

Hello All!

I just received my first denial from Cigna for a panniculectomy. They didn't deny that it was medically necessary' date=' just that it wasn't covered by my plan. I spoke to a fantastic rep with Cigna that urged me to appeal the decision but couldn't go into much detail about what they would want to see in the appeal. I vaguely remeber appealing for my band but it was 4 years ago and can't remember exactly what I did. The plastic's office won't help - apparently once they see there's a chance they aren't getting paid, they put their hands up. They won't even give me some tips of what the insurance company would want to see. I'm going to resubmit with the original documentation from the plastic's office, the lapband surgeon's notes and the photos along with more photos and a letter from my pcp. Is there anything anyone else has done to push that appeal through? Any tips or documentation I should include? I skimmed through other postings similar to mine and noticed that some members were offering sample appeal letters - does anyone have a copy I could check out?

Any and all help would be greatly appreciated!

Thanks,

-Emily[/quote']

Im pretty sure one thing insurance companies look for is if you get skin infections, raw areas, etc. from the extra skin.

[Antwan 9]

If you want your skin removed st vincent hospital in indianapolis indiana will do it for free if you agree too donate it too the burn unit for skin grafts

[lucie159 89]

If you want your skin removed st vincent hospital in indianapolis indiana will do it for free if you agree too donate it too the burn unit for skin grafts

If that's true, I will donate all my extra skin. They can have it all!!!! Do you have a site where I can go to see if this is the case? Or a number I can call?

[Antwan 9]

I forgot the website but you can call the hospital