MAJOR INSURANCE ISSUES

Its the ins job to discourage you against having surgery and make you want to give up so they can save $$$. Its your job to fight for what you need and meet the requirements so you can get what you need. I know its hard to be patient but you have to do. My doctor just submitted for approval for my revision Friday i am so anxious i wanted answer on Thursday. Lol Girl paitence is a virtue! But i am totally with you i dont get why once they get your file It takes 15 working days? I could see If they meant like we have a lot of files to get to and we will get to it within 15 days. but like I said its their job to make us frustrated and throw in the towel. good luck

I have Cigna too...  I've had nothing but issues with them this year....  Issues with my PCP visits, issues with my sleep study... figured I'd have issues with my approval... but - that went right through.  I actually printed out what was needed from Cigna and gave it to my PCP.  She then wrote the letter to what the insurance wanted.

Hopefully you have everything sent in now so you get it approved.  Mine only took a week to get approved once everything was submitted... 

Good luck!!

April

I have Cigna and my approval went surprisingly quick and easy.  They assigned me a case worker RN as soon as they got my submitted file.  I did get an initial denial stating they didn't get all of the info they needed, but the surgeons office took care of it. I never knew what was missing. I did not have a letter from my PCP but I had seen other doctors (cardiologist and pulminologist)  I assume one of them must have stated the medical necessity for me. I do know it was part of the requirement that a second doctor had to agree with the surgery.  It was only a week and a half from submittal time to my surgery. I had my date scheduled before insurance paperwork was submitted. I think the doctor did it this way to force insurance to give a quick answer.  Luckily it worked out, but I only got final approval about 36 hours before surgery. That part was very stressful. 

If they assign you a RN case manager he/she will help you navigate the denial process.

I have Cigna. My approval was fast but my surgeon had everything together in the 1st submittal. I will say this, though. Do not wait more than 2 days after your doc sends the paperwork over to call (at least to verify that they have received it). My approval was in 5 days. Be courteous when you call and they will help you all they can :)

Good luck!