Denied By Cigna

[ButterflyAMT06 9]

Well I called my coordinator today to find out what was going on and of course it went straight to voicemail so I called cigna to find out and they said I was denied so I asked why and she said I was denied because services has to be done at a contracted bariatric center of excellence and i asked was there any other reasons and the lady said no it was denied right away and my file wasn't looked into any further???? so I was like WHAT!!! and I said yes they are...Memorial Hermann-Texas Medical Center has been designated as a Center of Excellence by the American Society for Metabolic & Bariatric Surgery (ASMBS), which means we have met the independent and rigorous requirements established by the ASMBS. The ASMBS Center of Excellence designation recognizes surgical programs with a demonstrated track record of favorable patient outcomes in bariatric surgery(paste this section from there web site) so i told her to look it up and that my doctor is Chief of Elective General Surgery for the medical school Department of Surgery. He is also the Medical Director of Bariatric Surgery for the Memorial Hermann Hospital-TMC. she said she couldn't do anything else and to contact by dr. office so i did and my coordinator voicemail said to leave a message and she will get back within 24 hours. It has me just mad..you spend all that time to meet their requirments spend all that money for the out of pocket expenses and they tell you no right away and then you can't get any answers from the dr. office because the only person who has the answers doesn't call you back. I mean she didnt send a paper with a leader head stating they are a center of excellence or stamped it or whatever they use to identify that they are

So for those of you who do have cigna were you denied the first time and if so how many time's did you have to resubmit to get that approval...I need to call cigna to see if there is a limit on how many times you can resubmit before they say denied for a final time.

sorry so long

[xavtay2 85]

Hello! I have Cigna and just went thru the same thing. Word of advice Write a letter of appeal to the insurance company. I wrote a letter with the help of a family member who is an attorney. Points to the letter: don't be repetitive, state the facts with times names and dates, send them screen prints of what there site shows because the hospital my doctor was using was a center but because they were not a Cigna certified center of excellence it was a problem! State your reasons for filing the appeal and send it off. I was denied the beginning of June. Sent my letter 2weeks later and about 6 weeks from the time I sent the letter I received a call from Cigna with my approval! Go for it you stay encouraged and remember to send in the letter