Insurance Question

[Stacey Lynn 8]

Ok, so I received a letter of denial on March 1st for my surgery! My surgeon's office said not to worry the insurance co. was just "knit picking". After submitting another letter the insurance co. denied again saying they didn't have what they needed. I tried calling pre-certification myself to find out what's going on but they told me to have my physician call!!! At this point after 2 denials I'm not sure if they are going to approve it or not. I did EVERYTHING I was suppose to. I have thousands of dollars in medical bills already in order to have this operation. Has anyone ever had this happen to them???? By the way I have Cigna Ins.

[Geminidrive 389]

What exactly is the reason for the denial? Did you contact Cigna prior to all appts to obtain the required criteria?

[flmama 105]

Lindstrom Obesity Advocates. I was going to use them and spoke with Kelley, who was super nice and helpful. I found their rates super reasonable too. And when I emailed her to let her know I didn't need their services because I was (surprisingly) approved, she was very excited for me...which isn't what I would expect from someone who is losing my business, ya know? I don't know your specifics, but you can ask Kelley what sort of approval rate they have for your specific situation. For mine, it was 85-90%...I thought that would be worth it. For me, I can't go out country, because none of my potential complications or follow up care would be covered under my insurance. I know people self pay out of country and even in country and have no insurance to fall back on, but that wasn't a risk I was willing to take.

[Stacey Lynn 8]

My surgeon did a peer to peer review today and the insurance company still denied me. My coordinator told me that my physician did not write the exact words "cleared for bariatric surgery" and that 's why I'm being denied! So now I have to appeal it myself and either have my physician who by the way is on maternity leave now redo the physical or have another Dr. do it. I just can't believe I have gone through all I have to be denied because of something so trivial! My insurance co. sure as hell didn't have a problem with me being put to sleep for an endoscopy that's costing me $1200!!! Should I even go through with the appeal or just give up???????

[nakole73 34]

Don't give up!! You are doing this to improve your health and quality of life....I'm guessing