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Paperwork wasn't submitted with request for surgery



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Last Friday the insurance coordinator said she submitted my request to Cigna and we would hear something Tuesday or Wednesday of this week. I called Cigna on Tuesday and they told me my request was pending clinical notes from the surgeon's office. I called the insurance coordinator and told her what Cigna has said. She said she would call Cigna. When I called Cigna on Wednesday the status was still pending clinical notes. I asked what clinical notes they needed and they proceeding to tell me it is all the paperwork we have been getting together to submit to insurance.Can you imagine my frustration at this point? Couldn't get the insurance coordinator by phone or email on Wednesday. Thursday, the insurance coordinator sent me an email that the paperwork had been faxed to the case nurse. When I called Cigna on Thursday they said it takes 2 business days to decide approval and denied. I call this morning and got a great C. S rep named Patti. She had gastric bypass in 1999 and understood my anxiety. We talked for over 20 minutes. She said the approval could come any time today up to 9PM.

I was just wondering if the paperwork had be submitted with the request for surgery approval last Friday would I stil be waiting today?

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I have Anthem and I got the same run around for about 60 days. The insurance company kept saying they did not get everything and the surgeon said they sent it over. They both kept telling me to wait. Eventually I became a real jerk with both parties and micro managed the situation. Once I did that the surgery was approved in like 72 hours.

Good luck it will work out. Have faith and stay on top of it.

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I have Anthem and I got the same run around for about 60 days. The insurance company kept saying they did not get everything and the surgeon said they sent it over. They both kept telling me to wait. Eventually I became a real jerk with both parties and micro managed the situation. Once I did that the surgery was approved in like 72 hours.

Good luck it will work out. Have faith and stay on top of it.

Thanks Norman. I called Ciga at 8:51 tonight to see if the approval had come in. A recording came on and said they were closed. Call back during regular business hours between 8:00am

and 9:00PM EST. Beats me how 8:51 is not in regular business hours and I am in the eastern time zone. Well, Monday another day of calling and wondering.

So Norman, have you already had surgery?

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I had surgery 7/19. It flew by after the insurance approval. I know my advocate at the surgeon got tired of my emails and phone calls. But the day I called the insurance company and they said I was approved and will receive a letter in two days I was ecstatic. It was all worth it.

BTW since surgery the insurance rejected the surgeons bill saying it was not covered. I had to call them on this too. They said they would make an adjustment. Still waiting to see when that happens. I hate insurance companies.

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Good luck with the insurance Norman. They love taking your money and then balk when they need to pay out.

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What torture! :angry: Sorry you have to go through this. Keep us posted!

You are a sweetheart, thank you. Better be Monday or somebody has got some explaining to do.

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