CIGNA DENIED ME AGAIN!

[Ashoryb 52]

Just some info. that might help. Most insurance companies have people who just review cases for approval. What they don't want you to know is that most of these people have either no medical background or if they are doctors they are not bariatric specialists. Now tell me what sense is it to have a dermatologist reviewing cases for wls?? So call your insurance company and ask them who reviewed your case and what their credentials and qualifications are. They will tell you some type of specialist doctor. If it is not a bariatric specialist request one. But most of the time they don't want to tell you because it's not a doctor at all. It is just some random person like you and me. Be forceful and do not take no for an answer! You want your case reviewed by a wls doctor! I would be very surprised if you didn't get approved... good luck! I hope this helps!!!

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Thank you so much I will Def call them and get a Wls specialist to look it over. I wish I did have the money to go to Mexico but I dont. I will keep bugging them because I believe a weightloss specialist will see that I have medical necessity. Thanks yall for all your awesome advice I needed to vent to people who understand

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[Ashoryb 52]

My insurance wouldn't cover me at all. So I took came up with $ 4,300 and had the surgery in Mexico on 3/11/16. I needed a drastic change in my life and wasn't going to wait around insurance to cover me. Recovery hasn't been too bad, lots of liquids and Protein shakes so far. Looking forward to solid food but I know to wait until my stomach is ready to handle it. I started at 200, lost 7 on the pre op diet, just weighed myself and I am 182 :D . Oh my gosh it is working, cant wait to I get to my goal weight. If you can afford it, go to Mexico for surgery. I was treated very well.

Congrats on getting your surgery! I wish I could afford to go to Mexico for real. Keep me updated on how your doing

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[Ashoryb 52]

I would call them back keep your foot on their neck. that is what i am doing now. i was denied the first time they said it was missing information so everything was done and my doc resubmitted last wednesday im still waiting if i get a denial again i am prepared with plan a plan b and plan c....they can tell you over the phone you ask the rep to talk to a manager immediately they cannot deny you that that is your insurance that YOU pay for..

good luck hun.

I'm so sorry you got denied as well. It's like a gut punch isn't it..... I hope yours turns into an approval. I was hoping mine wouldn't be am MMA fight but I'll give them that if that's what it takes

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[kdelrosso 124]

I work for Cigna, and they denied my pre auth multiple times before they approved it. My surgeon did the peer to peer and was told that they would approve as long as he personally wrote a letter stating I needed the surgery and they still denied, my insurance coordinator called to our pre auth dept and got on the phone w a supervisor. Needless to say I was approved 3 days before my actual surgery. As long as your doctors office calls, whether it's to do a peer to peer or to get on the phone w their supervisor they should approve. Cignas coverage policy states that as long as the patient has a BMI over 40 , you don't need a co morbidity. I hope it works out for you

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[Jenrn1966 19]

What Doctor and hospital did you use ?

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[liposuction68 178]

Josiek1988 where are all the post from the insurance staff that was on here earlier backing insurance up..lol

[liposuction68 178]

PLEASE DO TELL OF YOUR TRIP TO MEXICO. WHO WHERE HOW MUCH EXPERIENCE EVERYTHING WERE YOU REFERRED OR YOU DID YOUR OWN RESEARCH ECT ECT CONGRATULATIONS.

[Alex Brecher 10,502]

@@Ashoryb,

I am sorry. It is such a disappointment. Let us know when you get that letter with their explanation. It’s probably something that will be infuriating, like they didn’t bother looking into it!

I am so glad your surgeon is on your side and will take it to the next level. I bet they know how to get through to someone at Cigna with decision making powers, and I bet Cigna will listen to them.

I am so sorry. You are not at all a drama queen. You are asking for something life-changing, you did exactly what they said to do, and all you got was a slap in the face with no explanation. Keep on it, if you can face it. Let us know how it goes.

[farooforever 20]

Cigna also denied my surgery twice indicating they were missing documents that were sent. I called them daily for a month and a half asking what the status was...what was missing... Who do I need to talk to to get an answer. My surgeon did the peer to peer review and it was accepted immediately. Honestly I believe their intake staff automatically deny for bogus reasons. They try to see who will give up. It should be illegal what they are doing to people who pay their premium in good faith.

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[Lexigurl82 160]

I am so sorry you were denied. I am glad your surgeon will do a next level appeal. Most times, the insurance company will approve it once an appeal is done. I hope you get the approval for your surgery. Please keep us posted.

[Ashoryb 52]

Ok yall here's an update.

I got my letter and they said they needed all the info on my previous failed lapband. It took some digging because the lapband I had was in 2008 removed in 2011. I did not even mention the band starting this process so not sure why they need all the info. They Arnt doing a revision so I didn't thunk it would be a big deal. They also said I gained one pound during my nut visits program which I did but it was during Thanksgiving and I lost the pound plus 6 more the next visit.

Grr. So any who my doc resubmitted all my paperwork for the 3rd time now so please throw up a prayer and good thoughts. I'm trying not to lose hope. Hugs to you all

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[tailor-made 33]

@@Ashoryb they shouldn't be asking for all of that. Seems like they are going out of their way to be difficult. What they asked you for is not even a part of Cigna's requirements...smh

They should have to answer for putting people through this mess!

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[tailor-made 33]

Forgot to mention that I'm definitely praying things work in your favor!

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[Ashoryb 52]

@@Ashoryb they shouldn't be asking for all of that. Seems like they are going out of their way to be difficult. What they asked you for is not even a part of Cigna's requirements...smh

They should have to answer for putting people through this mess!

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Thays what my doc was saying to. She said she has never had so many denials with needing such detailed information. She said they are probably MG hoping I will just give up. But I refuse

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Forgot to mention that I'm definitely praying things work in your favor!

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Thank you so much prayers are much appriciated

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[smonk76 6]

Oh man! How frustrating. I have Cigna too...now i am super worried! I have my appt with my surgen next Thursday. Idk what i will do if he has anything less than a surgery date for me!

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