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Round 1 denial by Cigna

Took 7 days and got my round 1 denial. My doctor need to both clear and recommend me for surgery. He only recommended me (inferring that he cleared me too.) Not good enough, he needed to state both.

My nut submitted discussion of the three visits in one report; Cigna wants it in 3 separate reports.

So on the plus side, these seem like minor issues that can be easy fixed. On the minus side , it's disappointing that Cigna is so nit picky!

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  • CCRNonherway
    CCRNonherway

    APPROVED!!!!! Surgery date 6-25!!!! Seems so soon! Took about 5 business days for appeal.

  • CCRNonherway
    CCRNonherway

    Submitted appeal on Tuesday. Hope it works this time!

  • Oh yeah, the waiting will kill you. LOL. It looks like you shouldn't have any problems this go round. Insurance makes everything hard.

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Mine was denied initially by CIGNA, also because my PCP didn't write "cleared" for surgery. It was corrected and a new letter submitted two days later. By weeks end, I had my approval. Hang in there, it will happen for you, too. Good luck!

  • Author

Thank you! I hope these are easily resolved!

  • Author

Submitted appeal on Tuesday. Hope it works this time!

Submitted appeal on Tuesday. Hope it works this time!

At least they are not saying that you don't qualify fior medical reasons....it seems to just be about crossing t's and dotting i's the right way....good luck!

  • Author

I agree! Thank you. This waiting is the worst!

I agree! Thank you. This waiting is the worst!

I agree!!

Oh yeah, the waiting will kill you. LOL. It looks like you shouldn't have any problems this go round. Insurance makes everything hard.

  • Author

APPROVED!!!!! Surgery date 6-25!!!! Seems so soon!

Took about 5 business days for appeal.

APPROVED!!!!! Surgery date 6-25!!!! Seems so soon!

Took about 5 business days for appeal.

Congrats!! I just got my approval letter faxed to me from my insurance...the surgeon did not even have it yet so I then faxed it to them, lol....they said allow 24-48 for them to contact me to set up a surgery date and pre op stuff...more waiting, so close yet so far....lol

  • Author

Congrats to you too! So much to do between now and then.

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