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Got Denied

Mensch

By Mensch, in Insurance & Financing

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Mensch    150

Mensch
Posted

Called Cigna today. Got the bad news. They say I was denied because my surgeon didn't send in a letter from an additional MD stating that I was evaluated and ok for surgery.

I called and left my surgeon's office a voicemail. I just assume that if the insursance coordinator in the office does this on a regular basis that he/she knows what to send in.

Guess I'll have to micromanage them now.

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SleeveandRNYchica    1,155

SleeveandRNYchica
Posted

That sucks, but I am sure you will set them straight in no time! It seems reoccurring with so many offices they forget something.

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PEvette    297

PEvette
Posted

Yeah, make sure you stay on top of that....they probably can appeal it and resubmit your paperwork with the missing info....

good luck! My District has Cigna and put a total exclusion for bariatric surgery for us....

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bmooney364    30

bmooney364
Posted

Amazing, but things like that happen all the time. You go and micromanage away. Hopefully you will get your approval soon.

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ALIGAYLE    20

ALIGAYLE
Posted

good luck! My District has Cigna and put a total exclusion for bariatric surgery for us....

What does that mean that your "district" has a total exclusion on bariatric surgery?

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PEvette    297

PEvette
Posted

What does that mean that your "district" has a total exclusion on bariatric surgery?

yes

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Silly Phylly    20

Silly Phylly
Posted

Called Cigna today. Got the bad news. They say I was denied because my surgeon didn't send in a letter from an additional MD stating that I was evaluated and ok for surgery.

I called and left my surgeon's office a voicemail. I just assume that if the insursance coordinator in the office does this on a regular basis that he/she knows what to send in.

Guess I'll have to micromanage them now.

So sorry to hear your news, but I for one appreciate you posting the issue. It helps others to know what to be aware of. I had a big disappointment as well. Informed by Doc that my BMI was only 39.18, so 6 month diet and frustration here I come! Sooooo upset! Hopefully yours is just some red tape and oversight that will be corrected soon. Continued good luck to you! :rolleyes:

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Mensch    150

Mensch
Posted

Well, they resubmitted on Friday. They have asked Cigna to call them if it's denied a second time. They seem to think that it's the wording that the Cardiologist utilized. More to come..

Didn't realized the emotional toll this has...wowzers!

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IMSKINNY    160

IMSKINNY
Posted

Well' date=' they resubmitted on Friday. They have asked Cigna to call them if it's denied a second time. They seem to think that it's the wording that the Cardiologist utilized. More to come..

Didn't realized the emotional toll this has...wowzers![/quote']

It is very stressful! While I was waiting for the ins, I started researching a Plan B. That gave me some solace. And just when Plan B was becoming Plan A, I was approved. So, hang in there! We've all been through it!

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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