Marycusa29 60 Posted July 22, 2013 I found out that Cinga denied me because of Medical Necessity....WTF!!!!! I'm not a happy camper. My BMI is over 40. I did everything they asked for. So know they are going to appeal. Stressed grrrrr 2 sthenny and PrettyThick1 reacted to this Share this post Link to post Share on other sites
Jim1967 3,569 Posted July 22, 2013 Cigna denied me the first time around because they were not satisfied with the documentation my Surgeon and Staff provided them. It was not until I provided exercise logs and food journals that they finally approved me. Don't give up and make sure your Surgeon and his Staff communicate directly with Cigna on your behalf. Good Luck!! 4 sthenny, DELETE THIS ACCOUNT!, PrettyThick1 and 1 other reacted to this Share this post Link to post Share on other sites
Marycusa29 60 Posted July 22, 2013 Thank You!!! Yes she told me not to worry that they will get it approved. So I really hope it does. I can't pay the money to do it on my own. So I'm keeping my fingers crossed. 2 PrettyThick1 and sthenny reacted to this Share this post Link to post Share on other sites
aviva1979 375 Posted July 22, 2013 I saw denied the first time (by CIGNA) because they needed an explicitly needed a Letter of Medical Necessity from my PCP. Was able to see her 2 days later, submit the letter the next day and was approved within a week. Hang in there! 1 PrettyThick1 reacted to this Share this post Link to post Share on other sites
dawalsh 919 Posted July 22, 2013 I found out that Cinga denied me because of Medical Necessity....WTF!!!!! I'm not a happy camper. My BMI is over 40. I did everything they asked for. So know they are going to appeal. Stressed grrrrr Most insurance companies deny the first time around. Mine did and after the appeal and medical necessity it went through. If you did everything according to the insurance requirements hopefully CIGNA will pass you and approve everything this time. Insurance companies are notorious for denying claims. They don't want to lay the big bucks if they can help it. Hoping for positive results on your appeal. Good luck! 2 Marycusa29 and sthenny reacted to this Share this post Link to post Share on other sites
Marycusa29 60 Posted July 22, 2013 Thank u all...I'm trying to stay positive :-) 2 PrettyThick1 and sthenny reacted to this Share this post Link to post Share on other sites
L1C4 5 Posted July 23, 2013 cigna also declined me. my bmi is 68! 68! and they said it wasn't medically necessary for me to get banded. Needless to say I appealed it through my hospital and they overturned it about 3 months later. Getting banded tomorrow 3 Cwalband, sthenny and PrettyThick1 reacted to this Share this post Link to post Share on other sites
Jim1967 3,569 Posted July 23, 2013 Yea they don't care about BMI unless of course you are under the requirement. I had a BMI of 78 and they denied on the first attempt. They're just real sticklers for proper documentation and I also think they deny with hopes people will just accept the denial and walk away. 3 sthenny, Marycusa29 and finallytime reacted to this Share this post Link to post Share on other sites
Marycusa29 60 Posted July 23, 2013 My info was resent back to Cinga. Keeping my fingers crossed. 3 sthenny, PrettyThick1 and aviva1979 reacted to this Share this post Link to post Share on other sites
babykins529 189 Posted July 23, 2013 I have CIGNA and I've heard its one of the hardest insurances to get approval from. They are huge sticklers on documentation so make sure its all there. My nurse was awesome and it only took four days to hear back with an approval on the first and only try. But I was a crazy lady making sure my nurse had EVERYTHING they needed and I jumped through all CIGNAs hoops. Fingers crossed for you! 1 Marycusa29 reacted to this Share this post Link to post Share on other sites
Marycusa29 60 Posted July 30, 2013 The office called me yesterday and told me cigna asked me to complete one more Nut. Visit so it can be approved. Cant wait!!!! 5 sthenny, Jim1967, MiniMi and 2 others reacted to this Share this post Link to post Share on other sites
babykins529 189 Posted July 30, 2013 Yay!!! Did you not do 3 months worth already? 1 Marycusa29 reacted to this Share this post Link to post Share on other sites
sp70 193 Posted July 30, 2013 Cigna denied me at first as well, wanting a letter of medical necessity from my PCP. Was leery with the wording from my pcp, because he didn't outwardly say he would recommend the surgery, but did say I would benefit from it. I was approved a couple of weeks later. Hang in there! 1 Marycusa29 reacted to this Share this post Link to post Share on other sites
Marycusa29 60 Posted July 30, 2013 I did the 3 months, but they are asking me to do a 4th one. I go on vacation on 10/10. So I'm hope its done early Sept. Share this post Link to post Share on other sites
Marycusa29 60 Posted August 22, 2013 I went today for the 4 month appt Cigna requested. Now the waiting game again. Cant wait to finally get aproved and have a date. Fingers Crossed!!!! 3 aviva1979, Jim1967 and sthenny reacted to this Share this post Link to post Share on other sites
