Cigna denied me AGAIN!

This is my third scheduled surgery that has been cancelled due to Cigna constantly changing the requirements they ask of me.  I am sooo tired and ready to give up, but then I think that is what they want me to do.  I just wish everyone could get on the same page and that there wasn't any misinterpretation between the insurance company, my PCP and the surgeons office.
Encouragement please.  Also, does anyone know how many times you can appeal a decision before they tell you they won't consider you anymore?

Why do they keep disapproving you?  I have Cigna and just got my denial letter.  They denied me because I don;t have the 6 month diet requirement.  Also, I was not able to document my BMI for the 2 years.  But my policy is self insured (by my company) and I am waiting for my company physician to override Cigna's decision.  Much luck to you.  Keep trying.  Don't give up.

It must be like a form letter becuase I am being sited for the exact same two things you are.  First time around they didn't tell me they needed the 6 month physician assist, then they said my first three months of nutritional visits would count and now they are saying they will not.
How do you find out if your policy is self insured or not?  I have CIGNA open access plus.  The BMI over 40 for 2 years is a new requirement as of May in my policy.

 Tangerine,I am new to writing on here so bear with me.I too have Cigna and I am on My
second appeal for not having a year of 40 bmi. When did you first send in you request
for the lap-band?Because if it was befor they changed to 2yrs.40 bmi then you can still
do the 1yr. from what I was told, also I am not sure but I think that the 2nd appeal is as high
as you can go before you have to start all over. Hope this helps some.

Sherrie

Actually I'm going for the RNY gastric by-pass.  After reviewing my latest denial though, we noticed that it was dated for 4-01-08 thought it was sent to me on 8-21-08.  It also had my previous surgeons name on it, he has since relocated to another hospital, so after calling my surgeons office they said that they had only recently submitted my paperwork and that they won't be hearing bac****il mid week of next week.  I am keeping my fingers crossed that there was an error and that i haven't been officially denied after all.  They really make you work for this though. You have to be right no top of everything and everyone.  Are you having bypass or lapband?

I am hoping to have the lap-band but it's taking for ever. If you started this process before
they switched to 2 yr. for the 40 bmi then you still get to do one year.
Good luck-Sherrie

i guess another thing that really scared me into switching procedures was that they said that insurance companies will only pay for ONE weight loss surgery procedure, so if I got the band and wanted to have a revision to the RNY they wouldn't pay for it, and it didn't matter if in a few years I had a different insurance. It is considered a pre-existing condition and I didn't know that.  I am still waiting to hear back.  Why is it taking you so long?

I guess we just have to do what we think is best for each different person. I am so afraid of any surgery and lap-band seemed the safest. I am  just a big chicken but I am 50 years old and have never had surgery before.I hope you get your surgery and I hope I get mine too!!!! Even if I am scared.I worry more about my health problems because of being over weight. This is nerve racking waiting on them to answer.

If you're worried about only being able to have one surgery, have you looked into the DS?

I am familiar with the DS, however my surgeon and the entire group will only do that surgery on a patient with a BMI over 50.
Also, I believe my insurance requires a BMI over 50 for that surgery also and I am just at 40.