Question:
Has anyone done the 6 month diet for Cigna and still been denied surgery?
How often were your weigh-ins, weekly or monthly? — Louise M. (posted on July 18, 2003)
July 18, 2003
Louise
I, too, am fighting Cigna. I had to start my diet all over again last
month. My PCP put me on another diet last Nov. but I didn't check in
monthly - had a few gaps so I had to start all over again last month. Now
it will be December before I'm through!! I check in monthly. My letter from
Cigna states "at least monthly check-ins". Good luck!
Sunie
— Sunie I.
July 18, 2003
Cigna denied me even though i showed 6 months use of xenical since i did
not have monthly weigh ins....I was denied. Just makes no sense though i am
working on an appeal as that is just them pulling stings to delay the
surgery in my book
— jellyin
July 18, 2003
One can only hope there is a Hell and these insurance administrators spend
eternity there!
— Chris T.
July 18, 2003
for my approval through cigna hmo, i had to have 3 months of dieting
documented. the funny thing about this is that my doctor submitted my
request for open rny a two months into the dieting. well cigna not only
denied my open rny request, but they cancelled my approval to see my
dietian one more time. anyway, we appealed their decision with more
paperwork. they wanted official weigh-ins over a year's time to be
documented. what we ended up using was the sheet of paper my PCP
maintained when i went to him for appointments. you know how they take
your weight and blood pressure every time you set foot in a doctor's
office? even though it wasn't associated specifically with dieting, that
was fine. also, i believe cigna does a blanket denial no matter what the
first go around and then they go back during the appeal process and take a
look at those people who were not deturred. i talked to a rep on the phone
and she told me confidentially that cigna approves a lot of these surgeries
and it isn't an issue of not wanting to pay, but an issue that they want to
make sure there will be no complications. i hope that helps.
— Jeanie O.
July 18, 2003
I too have CIGNA and they required me to have 12 weeks of monitoring in the
last calendar year. I of course only had 8. So, I just finished another
twelve and my surgeon is submitting it on appeal this week. If you email
me in a couple of weeks, I'll let you know how it went. I went every four
weeks to check in TO THE DAY. Meaning every 28 days. Make sure your
physician is writing something in his notes about how much weight you've
lost or gained and what you tell him about what type of exercise you did
for that month and how often you did it. The letter says diet and
exercise, so you want it all included in his notes. Feel free to email me
in a couple of weeks and I'll let you know if I get approved.
— Kimberly S.
July 19, 2003
I too was just denied by Cigna PPO. I was told on the phone that they want
1 supervised 6 month diet and my surgeon's office was told they want 2 diet
and exercise weighins weekly! I don't think they know what's going on in
their own company! I am starting the appeal on Mon and my surgeon's office
has given me the name of an atty's office in Calif. if I'm interested. I
hope it doesn't have to come to that!!
— mary M.
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