Question:
Has CIGNA approved surgery before but after surgery wanted more info before they paid

I had my surgery on 09-29-00 with CIGNA's approval and so far they have not paid. Now they are asking for my medical history and problems related to my weight before they will pay. Has this happened to any one else and can they do this?    — T. W. (posted on January 5, 2001)

January 4, 2001
I have CIGNA PPO and am scheduled for surgery in Feb, waiting for approval from CIGNA. The asked for that info after my first request. They still have not approved but neither have they denied. If they sent you an approval letter (ie. put it in writing) I don't see how they can back off now. I'll be interested in hearing how this works out. Good luck Karen
   — Karen F.

January 4, 2001
I had to fight with Cigna for approval and had my surgery on 12/28/00. They can't do this. They had enough info to make the approval - let them know that you know they're trying to stall or pull a fast one & you will get you attorney involved. They should back down & pay.
   — Lisa B.

January 5, 2001
Hi! I have Cigna HMO and had my surgery 9/13/00 with full aproval. After the surgery they sent a letter that stated they were only going to pay for one day as it could have been done out-patient. I wrote them a scalding letter as I an a utilization nurse myself and requested they show me their criteria for this decision and basically called them stupid. They paid all of the bill except $500 which the hospital is now trying to balance-bill me. I am now fighting with the hospital, because with an HMO I don't have to pay anything, plus I got them the extra days. You have to fight with Cigna, but keep on them and they will pay.
   — Barbara S.

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