I'm Trying To Not Blow Up!

[barbi1281 112]

I finally got my answer from Cigna and it was "denied" because "medical necessity was not established" since my "bmi was only between 35-40" and I had "no comorbidities"... Oh and apparently I did not do the required supervised nutrition/diet program.

Notice all the quotes? Because I'm pi$$ed! It's a bunch of crap... only between 35-40? I'm 5'0 and staring at 200 lbs... on a small frame! I'm built small... was small until I was 24 then packed on lots of weight... that's HARD on the body. In addition to my back and hip problems (at 30 years old!) my right knee has started to hurt when I stand or walk - but dear me - I only have a BMI of 37! And I LOVE LOVE LOVE the no comorbidities... I'm on 8 asthma medications b/c I like shelling out 300 bucks a month for copays and God knows the nebulizer that I have to carry is an awesome accessory . Even better is the narcotic cough suppressant that I've been on for 7 months b/c of the type of asthma that I have and the nasty looks I get because I have to park in handicapped. I know that's not enough but maybe the GERD that has me on daily meds and still eating TUMS like they're a food group might qualify. NO? Ok ok how about the fact that I'm prediabetic and prehyperlipidemic while both of my parents are full blown both! I know to the insurance companies those things don't matter... but d@mnit I even had the gold star of sleep apnea (otherwise that doc lied to me to get me that fancy elephant looking machine ). SO WHERE EXACTLY DO I NOT HAVE ANY COMORBIDITIES?!?!

To answer the obvious, yes I did my nutrition and yes it was sent in - I don't know what Cigna did with it... they probably have it but overlooked it. And if I didn't do it then I want the money I paid for it and the hours I spent there back!

I'm so mad right now b/c it's Friday night and my doctor cant do anything about anything until Monday and I'm a fixer so I am trying to keep myself from calling these morons and telling them that they need to look through the paperwork again

[Oz Ley 9]

I sure hope this gets straightened out for you, I would be upset too.

[billyvmom 128]

Appeal it!!!

[joyful noise 101]

I agree with billyvmom. Appeal. I am pre-diabetic and that was listed as a co-morbidity. Cigna seems to be hit or miss. I am glad to have been approved quickly, if only the surgeon's office did't drag their feet.

[Crystalite 26]

Sorry that they are being awful.

[Patienlywtng on my Curves 73]

I know it doesn't help now, but when Monday comes, ask the Dr.'s office to do a Peer to Peer review. Ask the coordinator about the "missing" paperwork and resubmit.

I called Cigna a couple of times myself, so I know it can be frustrating. It will work out the best for you.

[CBT 450]

You can complete a Friday Night Appeal on line

life is a journey, not a destination; so, stop running -H.D. THEROUX