CIGNA people-How long did it take for approval/denial?

[Donnajade 0]

Big Fred - thanks! I have been reading everything possible on this board about cigna and was prepared to fight the fight. I'm glad I don't have to do that and I would love to swap stories. I'm sending positive thoughts your way and I just know you will get the approval word soon.

Donna

[Thor 0]

would love to hear from anyone who has BCBS of Illinois and what their experience was like My papers went in today after doing eveything they ask, and I mean everything!!!!!

[Big Fred 0]

Well, the insurance (Cigna) saga continues.

I am starting to believe that they are truly against us !!

Recieved a copy of a letter to my surgeon yesterday stating that were in receipt of my paperwork but needed clinical information for medical necessity. I called the office, they told me not to worry that they (the insurance co.) do this everytime. It is a form letter that they send out immediatly after recieving the paperwork (probably to delay the process). The information they requested was sent to them and the office will confirm this today.

So here I am, waiting again. If I do not hear back from anyone by Monday, I'll call the insurance company myself.

Still waiting in CT..........

[Shelby 0]

Hang in there Big Fred! It's not easy and so frustrating but don't give up. Cigna is known for delays and denials - they want people to give up and go away. Not you - you can do this!

[Donnajade 0]

Big Fred - I'm thinking about ya and sending good vibes your way. It will happen soon - I just know it! How long have you been doing this? I know you had to do the 6 month thing but did you start before that - looking into this and talking to your Dr. I'm sorry you're having this problem.

Donna

[Big Fred 0]

Donnajade,

Thank you for the good vibes, I certainly can feel them.

I started this road about a year ago, went to a seminar and talked to the office staff last summer (2006). It took me until this March to make the decision to have the surgery ( I like to do research).

Once I made up my mind, I asked the insurance coordiantor in the weight loss center what I needed to do to satisfy their requirements. So, I guess you can say the process started in March. I had everything documented, office visits, psych visit, stress test, blood work, nutritionist visits, gym visits, etc....

I spoke to the coordinator about the recent letter, she did contact the insurance company the same day I called her and low and behold they found the missing paperwork (it was there all along - imagine that). She told me that Cigna has been taking 3 to 4 weeks to make a decision. So I guesss I have to wait.

Thanks to all for your supporting words, I appreciate them all.

[Donnajade 0]

Big Fred, I started about 8 months ago. A friend asked me to attend a meeting with her. I had never even heard of the band - I had heard of bypass and at one point about 2 years ago had thought about that. I decided very quickly after doing research that it wasn't for me. But, when I heard them talk about the band I got very interested and started doing research. I think the first thing I did was find this board and the second thing was talk to my Dr. At that point I called Cigna and asked about the morbid obesity rider. They were actually very helpful every time I called (and I called a lot!) The coordinator at the center where I'm having the procedure also told me that Cigna would take 4 to 6 weeks to make a decision. I called Cigna and asked how long it would take and they told me 3 days. You probably already have called them but if you haven't, you might want to ask about the time frame. Just a thought.

This will happen for you! You will be banded in Oct.

Donna

[michiganer 0]

:faint:

Well, I have been denied by Cigna. My paperwork was submitted to them on September 20th and I got the letter dated September 28th this weekend. So needless to say, it was a crappy weekend. I was doing really good on my no-carb diet too and I totally fell off the wagon all day yesterday. I am back on today though. The letter basically regurgitated all of the requirements you have to pass for them to approve you. I am confused because as far as I know, I have met all of them. I spoke with the insurance coordinator who has been extremely helpful though this whole process. She said she also got the letter and doesn’t understand the reason for denial either. She said I have met all of their requirements. I really feel like calling Cigna some really bad names right now! I feel like I have jumped though a million f-ing hoops for them and then they have the nerve to send me some cryptic freakin letter. It really pisses me off! But I have confidence in Amanda (the insurance coordinator). She said that she is going to have Dr. Kim (the surgeon) do a peer-to-peer with the medical director (I think she meant Cigna) to find out what the problem is. Dr. Kim will be in surgery today and tomorrow so the earliest he can do it is Wednesday. I am tired of waiting but what is a few more days after I have been going through everything for months right? I am still confident that Cigna will approve me eventually. I have done all they asked and I am sure that they are just being nit-picky. Once Dr. Kim calls them, I don’t think they will be able to weasel out of approval. Pray that they approve me soon! I want to begin my new life! * Trisha *

[Big Fred 0]

michiganer,

Did they say why you were denied?

I too am going through this insurance nighmare, my paperwork went in 9/18 and have not heard anything from them yet (maybe no news is good news).

My prayers and wishes go out to you, I hope that your doctor can knock some sense into them. Wishing you all the best....

[michiganer 0]

Big Fred,

The letter I got was almost 2 pages of medical terms and their requirements for approval of the lap band. As far as I can tell, I have met all of the requirements so it really is a mystery. Someone on another board said their spous was denied but was approved after the peer to peer review. Even the insurance coordinator didn't understand the denial reason. I am hoping once the doctor gets involed, I will get approved....

[Forestcat5 1]

michiganer - Hang in there. I was APPROVED today by cigna after being denied by them about a month ago. And I believe it was the "peer to peer" phone call my pcp made that got me approved. She faxed over more details of my medical history, and called, and BOOM!....it all came true.

So hang in there, don't call them any names yet (ever wonder if they read these sites?!?) and make some phone calls to your surgeon and pcp if you have one, until they find out what else cigna wants, fax it, then do the peer to peer.

Good Luck, and keep us informed!!!

[jennypoo1 0]

Hi I have Cigna insurance and was initially told they approved the lap band. 3 weeks later when the place i was going to get it done called, they were told all gastric surgeries were excluded in my plan. How can this be! I cried for 2 days cuz i had my heart set on doing it in Jan 08, but I cant afford to pay $16,000 myself! Help!

[jennypoo1 0]

Just a quick question. Did they tell you that gastic surgeries were excluded from your plan?

[Forestcat5 1]

jennypoo,

I called cigna the day after I went to the lapband seminar. I just had to give them the info off my ins card and they looked it up, and they told me it was covered IF I met the requirements. I think it all depends on what your employer has specifically included in the company insurance coverage.

Call cigna again and explain that you've been given 2 different answers, and you NEED to know which one is correct. And if you're comfortable with it, call your HR dept and ask if it is covered.

Keep trying! Good Luck!!!

Forestcat

[jennypoo1 0]

Yeah it was strange cuz when i first called she told me I qualified cuz of my BMI and she had to pull up my policy, so how could she get it wrong! I am going to call my HR dept. Due to my job I will never see them cuz their located in florida. Thanks for the encouragement!