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Cigna- Nightmare

Pumpkinmeli

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Pumpkinmeli    15

Pumpkinmeli
Posted

I have been in a nightmare with Cigna for weeks now. Since August 23rd to be exact. My surgeon sent over 36 pages of documents to Cigna for approval. Including all clearances from doctors, weight check ins for 6 months, reccomendations for surgery from multiple doctors. I get a letter of denial saying they need more information to prove medical nessescity. We discovered that they didnt recieve the fax with 36 pages... so they re-sent. Then on August 31st I get another denial saying they needed a letter from my dietician, a letter showing proof of a BMI over 40 for 12 months and a letter from a physician approving the need for surgery (which they ALREADY had). My surgeons office RE SENT for the 3rd time marking it URGENT. I called this morning as it had been 48 hours since they recieved the fax marked urgent. They said that it would take 5 business days before they would do a reconsideration plus 48 hours to return an answer. I am 13 days from surgery and still have 2 pre-op appoinments that they wont schedule until I get approved. There just isnt enough time. I cant move my surgery date since my boyfriend can only take off certain days because of they type of job he has. Plus I have a wedding in October to go to... and have to be feeling good enough to go... at this rate they would have to push back my surgery to the end of October which doesnt work for my work schedule. I am disgusted with Cigna. Luckily I work for Human Resources and my boss happens to be the director of benefits. I had my surgeon fax over all 36 pages to me and I have given them to my boss... she is calling our Cigna rep and is going to go above the medical directors head to try and get this approved today. PLEASE pray for me... I cant take another denial. I am running out of steam and I am SO stressed. Good thing all I can eat is Protein shakes... I dont think I could keep anything else down. :(

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nyxa    159

nyxa
Posted

i hope everything will go well & you will get approved. i'm sorry you're having so many problems with this stuff. i'm sure everything will work out. :) i will pray for you! keep us posted, please!

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sandsmom3    2

sandsmom3
Posted

Wondering how it is going? I too have a date for 9/25 and still no confirmation from Cigna. I have done all my pats and pre op visits are this week. I have taken the week off, so has my husband. It HAS to happen on the 25th.

I have not called the insurance myself...should I?

Good Luck to you!

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Pumpkinmeli    15

Pumpkinmeli
Posted

Deffinately call Cigna... I called almost everyday. They are the most difficult insurance company to approve the sleeve. They are quicker with Lapband and Gastric bypass but with the sleeve being still kind of new they are EXTRA carefull. My clearances and everything were sent in on 8/23... I got my final approval on 9/12. I went through every hoop they threw at me and my doctor had to get involved at the end to do a peer-to-peer. I am like you.. I took off work and so did my boyfriend... we couldnt change the date from September 20th so the pressure was on. I have my pre-op appointment on Monday and just today did the blood work. Good luck!! I hope you hear back from Cigna soon!!!

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valdostaGA    149

valdostaGA
Posted

Praying for an approval for you!!

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sandsmom3    2

sandsmom3
Posted

SOOO FRUSTRATED.....still no approval from Cigna....MD office wants to reschedule from 9/25 until I get approval. I called myself today...they said they received info on 9/6 and it went to medical review on 9/10 and they have up to 30 days for decision. They will mail a letter...so MORE time spent waiting.

I have all this planned.....vaca...husband vaca...and 3 kids who are very busy (3 under 9)

Any suggestions??? MUCH NEEDED PRAYERS!!

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Ready4success    380

Ready4success
Posted

SOOO FRUSTRATED.....still no approval from Cigna....MD office wants to reschedule from 9/25 until I get approval. I called myself today...they said they received info on 9/6 and it went to medical review on 9/10 and they have up to 30 days for decision. They will mail a letter...so MORE time spent waiting.

I have all this planned.....vaca...husband vaca...and 3 kids who are very busy (3 under 9)

Any suggestions??? MUCH NEEDED PRAYERS!!

What plan under Cigna do you have? I was told with Open Access, they had 5 days after going to medical review to make a decision, if all the requirements were met. You need to call everyday! I knew that I was approved before my surgeon's office, and the letter didn't come until the following week. Call everyday, so you'll be the first to know. It doesn't matter that you're bothering them, that's their job as reps. Also, if you have a pre-op diet, start it so that if you get last minute approval, you can still go on the 25th.

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TapSnap    357

TapSnap
Posted

Not what I really want to hear since I have Cigna. I still have 3 more months before I have to start worrying about this but I rather hear good things about Cigna.

Hope everything works out.

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billyvmom    128

billyvmom
Posted

I have cigna open access plus and I was approved in 5 days. I called everyday to make sure. I would suggest that. I am proof they do approve it. Be persistent and good Luck!!!

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Ready4success    380

Ready4success
Posted

I have cigna open access plus and I was approved in 5 days. I called everyday to make sure. I would suggest that. I am proof they do approve it. Be persistent and good Luck!!!

I have Cigna Open Access Plus too, and was approved in 5 days also. I called everyday, and called my surgeon's office to tell them when I was approved. Call everyday!

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Patienlywtng on my Curves    73

Patienlywtng on my Curves
Posted

I too have Cigna. There was a glich initially but then the approval was rather quick. I agree that it depends on the type of plan but 30 days seems a bit too long. Besides my Surgeon's office would call as well.

I didn't start calling until we were trying to get a flight for my mom to be here. So call Sandsmom

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UTGal99    327

UTGal99
Posted

I have Cigna Open Access too and I was approved in 5 days on the first try. I would call and demand to speak to a supervisor to understand what is taking so long. Good Luck!

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cmcl127    8

cmcl127
Posted

This concerns me as I also have Cigna -- the surgeon's office did tell me that they can be difficult to deal with. The office will fax over information to Cigna and they say they never received it. I have a tentative date of November 7th -- so I will keep on top of the insurance company. Thanks!!

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tigerbelle    328

tigerbelle
Posted

I hope all works out for everyone...just to make you all feel a little better--at least you have the chance to get approval and coverage...my insurance (State of Louisiana) does not even consider coverage of bariatric surgery, so I will be paying myself for the entire process

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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