Question:
How can I get my insurance company to finally give me an answer on approval?

I am scheduled for surgery next thursday (august 1st) and I still do not have an approval from my insurance company. My surgeon's office sent in the paperwork to the insurance company on June 26th and it was input into the insurance company's system on June 28th. I keep getting the run around from Cigna about my approval. On Monday, they told me I would have an answer by today. Well, still no answer and now they are saying they don't know how long it will take. I've been given a timeframe that it could take 30 days, then I was told 15 days, then 30 again and then this morning it was 20. They never give me a straight answer and keep giving me the run around and then told me today that if I don't have an approval by next thursday, I will just have to reschedule. Is there anything that I can do to expedite an answer from them? I have not been getting any help from my surgeon's office either. I have called the surgeon's office every day since Monday and twice today and still no response from them. I'm going up and down on this emotional rollercoaster. Sorry its so long. You can either respond here or email me at [email protected] - thanks for listening!    — Giovanna G. (posted on July 24, 2002)

July 24, 2002
I was getting a run around with BC/BS State of Maryland, so I contacted someone in my Human Resources department. She was able to give me the name and phone number of the director for the Maryland Operations Center. The director gave me the phone number for the BC/BS account manager, who specializes in these kinds of problems. She got to the bottom of things and I had approval in a few days. It also doesn't hurt to threaten with the Insurance Commissioner. Good luck. I hope things work out for you.
   — Kathy M.

July 24, 2002
Your insurer's handbook should contain information on how long they have by law to respond to your request for approval, check it out. I would not hesitate to mention, very nicely, that I'd been patient, have felt like I couldn't get straight, definitive answers to my questions, and if they didn't tell you when you could expect approval or connect you with someone that could, you would have no other recourse than to file a complaint with the Insurance Commissioner's office in your state. I feel most insurance companies have 30 days to respond, and you're very close to that. If they go over the time allotted for granting approval, it seems they would be violating their contract with the company you work for. Tell them you're going to be calling again and again until you receive satisfaction and the one thing that you won't be doing is going away. Good luck, Jo-Dee
   — tinyjo