G-LO

I got a second Denial letter in the mail. Saying i dont meet the Cigna requirements. Does any one know what those are? The first letter I got said I havent met the 6 month nutrionist consult and i had 45 days to appeal. So i figured Maybe I can take into account when I first went to my doctor in April to be considered for the Surgery. Anywho, I went back for my second visit to the Nutrionist and she agreed to give me a recomendation for the surgery. So she wrote the letter and my dr. sent it to the insurance and I got denied saying i havent met the Cigna Requirements and the 6 month nutrish. I dont want to give up but its not looking good. Im wondering if anyone has been approved by cigna. If so any suggestions?

jillfrie

Have you contacted Cigna and asked them the requirements? If so, get it in writing, they should mail or fax you something. Is your surgeon's office any help to you? Mine practicallly walked me through the process. Good Luck

__________________

Jill

Date of surgery 10/9/06

Blueyz

Don't give up...I was denied and I think they wanted to see if I was serious or not. I had Blue Shield HMO though and they wanted 6 months of documented supervised weight loss. I would call Cigna directly..speak to the medical director of your group and ask them exactly what is it that you need. Just don't let them say no...it is worth it to find out and fight if you have to.

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Blueyz
Open 7/14/04 w/Dr. Callery 4 years out
239/103/125 below Goal fluctuating between 108-115
BMI 18.8~Dr. C is ok with my weight...yeah

Official Scale Whore # 27 (Recovered..I threw mine out!!)

cassie7978

Don't give up just be very persistant with them..... I just got approved from Cigna in less than 24 hours the first time we submitted.. I called every dr that i seen in the last 5 years and got all medical records that had any wieght documentation on it, I had 6 months weight loss program with pcp and I had 3 months nutrician classes and my psych evaluation and I also has 2 letters from 2 different Dr"s stated that it was vital to my health to have this surgery because I have exhausted all other measures... Be presistant, Dont let them get discuraged send in everything that you can get your hands on for as many years back as long as it has your weight on it... call, call and call they'll get tired of talking to you... Trust me by the time my dr submitted my information the people at the insurance company ne me by name... Good Luck Keep your head up!!!

LoriAnn925

I was approved thru Cigna (open access plus) however not on my first try. I started my process back in January. I went to the seminar, did my surgeon consult. But I also researched Cigna's requirements and knew that I would probably be denied the first time. They require a 6 months PHYSICIAN MONITORED weight loss program. That means that your doc has to take the right notes, and that you have have appointments every month for 6 months in order to be approved. If you go to their website and search for gastric bypass you will be able to find their requirements. My surgeon first submitted in March. I was denied. But knowing that I didn't have the full 6 months with my doc, I started the appts in feb. I took her a copy of what cigna required as far as documentation, and she took the right notes. I got my denial in april, and kept seeing my doc. I had the surgeon re-submit at the end of july. Cigna finally got the paperwork the first week in august, I was approved in 2 days. If you meet their requirements, they are very quick to approve. But if you don't, they will deny you.

You can also call them, and ask for specifics on why you were denied, and they will tell you everything you need to do.

If you need help finding the requirements, let me know.

Don't give up. It could take another 6 months, but you can get there.

__________________
LoriAnn 5'7.5"
Lap RNY: 9/25/06
307.9/154.6/145
Pre-Op(highest)/Current/Goal
Last Edited 4/28/08

Century Club - 3/31/07
Onederland - 4/30/07
Size 8: 12/15/07 -- I have reached Single Digit clothing sizes!!!!!
LESS THAN HALF OF MY STARTING WEIGHT!!!!! - 12/24/07

TT Gym Rat #20
"Destiny is no matter of chance. It is a matter of choice. It is not a thing to be waited for, it is a thing to be achieved." - William Jennings Bryan