CIGNA really screwed up this time.....

[Sharon1964 2,530]

After a week full of non-stop battle, Cigna has decided to make right of their error. I can't think you all enough for your comments and suggestions. You all are the best!!

THAT IS SO FREAKING AWESOME! You must be on cloud nine!!!

[losinit512 12]

Cloud nine is an understatement, haha!! I was out to lunch with my son and was starting to feel defeated but I couldn't make myself order anything unhealthy. I'm so glad I stuck to my guns because right when they brought our food out, the phone rang with THE call. I'm so excited!

[smkallen67 31]

I am hoping what happened to you isn't happening to me.

My docs office submitted almost 2 weeks ago and today Cigna said they didn't have all the info they needed and was going to deny (via letter) when everything they said was missing WAS submitted. The doc office is resubmitting today what was missing and hoping for approval. Just BS that they say stuff is missing when it's their in front of them to hold up the process. Very frustrated. Wanted to hear accepted this week since I did all I was suppose to and all was submitted. UGGGH! No guarantees I understand even if you meet all the qualifications. Just have to pray and be patient something I am not very good at. And why are they approving and paying 80% of all the prep appointments for surgery if not going to approve surgery. Crazy

Sue

[woo woo 872]

Cloud nine is an understatement, haha!! I was out to lunch with my son and was starting to feel defeated but I couldn't make myself order anything unhealthy. I'm so glad I stuck to my guns because right when they brought our food out, the phone rang with THE call. I'm so excited!

I'm so happy for you!! I'm glad you decided to fight.

[losinit512 12]

Hi Sue,

I hope you're not going through the same thing I did either. That's something I couldn't understand either - why they approved everything up until the last minute. Patience is not my friend either and it was one LONG nerve-wracking week of fighting. I guess the only advice I can give is to keep pushing up the ladder. If you can't get a response from who you are talking to ask for a supervisor. I hated having to do that but I just couldn't settle with them telling me no. I have a close friend who is going through this as well. Her surgery is scheduled for July 14th and she is also having to be persistent and fight. I'm beginning to think the denial process is becoming standard practice among the insurance companies.

Good luck to you and keep me posted on how it goes!

Nancy

[Sharon1964 2,530]

And why are they approving and paying 80% of all the prep appointments for surgery if not going to approve surgery. Crazy

Sue

Because those things are not surgery, they are office visits, radiology, etc. Pretty much everything I had done before I was approved could be done for someone not having surgery.

I had:

Surgical consultation

nutritional counseling

psych evaluation

upper and lower endoscopy

colonoscopy

pap smear

lab work

[LSF 264]

I have Cigna. I knew the "revision" surgery I wanted was covered but when the paperwork was submitted it was denied. I called and found out that the denial was only because they wanted it done at a different hospital so we re- submitted the paperwork. It was approved immediately and my surgery was 5 months ago. Good luck

[tstarkey704 21]

Here is a link to the most recent info about the procedure coverage from Cigna. Hope this helps ????????

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

[lmhelmick 79]

I got denied through cigar as well on first attempt. Said they didn't have all the proper paperwork. Dr office resubmitted the same day they got the denial and it was approved the following day. Funny thing js she submitted everything the same as she previously did. I think it's just laziness on cignas part. Glad u got your approval