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Originally Posted by KnighTron
Why didnt you just start your visits with your pcp? I have cigna and they require the same 6 month vigil. Instead of arguing with them I started my visits. When I completed the visits they approved me in 2 days....no fuss, no muss. Why do you want fight? Just comply.
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I talked to Cigna, and I talked to my doctor who said Weight Watchers is acceptable, AND I talked to my surgeon's office who has experience dealing with HMO's.
As for "complying", I've done everything Cigna has asked. I've ensured all paperwork has been submitted as requested, and all required tests and more have been completed. Most of all, I've been patient, everyone on this forum who knows me, understands how patient I have been.
My question to you is, why would I NOT comply? I'm not looking for a lawsuit, all I want is the insurance company to provide what they say they will. Is that to much to ask? My doctor and surgeon also wrote a letter explaining this is medically necessary, and why. My HMO has been draging their feet, and coming up with new and additional requirements. All of which I HAVE COMPLIED.
By the way, according to the California State Department of Managed Health, it is not a requirement of the state to have the "six month" diet. In other words, the HMO can not force this on the patient.
Complience? I talked to the state Managed Health to file a grievance, and was told I first need to file one with Cigna first. This process takes 30 days. If the HMO once again denies me, I can, and will, go to the state, who will then deal with the issue. By the way, this will take an additional thirty days.