Question:
CIGNA DENIED ME!!!!
I am absolutelt frustrated and depressed and feeling hopeless. I found out today my insurance company, Cigna HMO, denied me. I went with an in-network surgeon, and I had five years of diets (under physician supervision), I had a great letter from my PCP saying I had osteoarthritis and other co-morbidities, I had a BMI of 42.2, I did everything by the book, my certificate of coverage only requires "medical necessity", I have REALLY, REALLY tried every diet in the book and I feel like a complete failure! Why would I not get approved?!? I called the insurance commisioners office and they referred me to the federal dept of labor employee benefits dept. I talked to a man there who acted as if he could definately help me fight this. He told me to have the surgeons office fax him my file, but the secretary at the drs office said she would prefer waiting til we found out why they denied me and then going from there.The problem is I am on a time line here, because of School (I attend a University)and also my husband may be getting laid off, which would mean changing insurances AGAIN... I am disgusted. I just wanted to vent! and any advice would be greatly appreciated. — kjonhjk (posted on April 11, 2003)
April 11, 2003
— beeda
April 11, 2003
My situation is a little different from yours, but I'm dealing with the
same insurance company. If your plan only requires medical necessity, and
your Dr. did the letter providing weightloss history and co-morb's, you
should have what you need. Did you call Cigna to find out why you were
denied? You should be able to get that info by calling the number on your
insurance card. I could be as simple as the wrong code on your doctors
submission. Definately wait until you find out the reason.
K
— Kimberly S.
April 12, 2003
Hang in there. If you have your ducks in a row (and it sounds like you do)
call Cigna and ask WHY it was denied and go from there. Cigna is FAMOUS
for turning down ppl on the first try becasue sometimes ppl will give up
and not try again which in the long run saves Cigna money. Its a business,
your life doent mean a thing to them. KEEP FIGHTING and keep your chin up.
It took me 3 times before I finally heard the magic words "you are
approved" I know you will hear those same words too. Please dont
give up, it really is worth it. Sidney Open RNY 10-23-02 down 80+
— Siddy I.
April 14, 2003
Sorry to hear of your insurance problems with Cigna. When doing your appeal
to this current denial. Find out who the medical director is of your local
Cigna office. You get this information by calling your member services and
asking for this information.
Your doctor and you can make an appeal straight to the medical director.
It works better for your doctor to write a letter send it via fax straight
to the director's office/secretary, and then have your doctor do a follow
up phone call in-person to Cigna's medical director.
Good luck!
— Lisa Pitzer
April 16, 2003
Check my profile, Cigna denied me 3 times so I took it to the state
insurance commission,I had all the documentation plus 3 doctors' support,
finally was approved after 9 months.
— Kay B.
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