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Cigna OAP require 3 or 6 month for approval

JacobsMommy

By JacobsMommy, in Insurance & Financing

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Luckyinluv    30

Luckyinluv
Posted

Wow, I just called Dr again and left another message. Told them I had very high anxiety and Asked if we could resubmit or do a peer to peer. Sure is almost here and wanted to enjoy it!!

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Jersrose43    837

Jersrose43
Posted

I called Cigna and spoke to them. The nurse reviewed reconsideration and notes were everything present but 4 visits in 78 days won't meet requirement.

She said it now sits with the medical director for up to another 5 business days for final reive and approve/deny.

Ridiculous

Am calling doc in am and scheduling an appt before end of day. Get that one in there and submit that really quick!

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Calimomof3    20

Calimomof3
Posted

Gosh - I haven't even had my paperwork sent in yet - I'm getting real concerned and wondering how long it will take... the doctors office feels it will get approved in a week or two and have me scheduled for surgery at the end of May but I guess I better not get my hopes up too much by the sounds of everyone else's issues. I'm praying for quick approvals for everyone here!!

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JacobsMommy    27

JacobsMommy
Posted

Because I am impatient, I called Cigna and my case has been assigned to a nurse and I should have a status on Monday. ..here we go, a nerve wrecking weekend ahead.

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star21nd    34

star21nd
Posted

OMG my husband tells me I am the most impatient person in the whole world...I want to call too but I have no idea who to call. I have never called Cigna. Maybe ill email the girl who summited the claim. It is going to be a long weekend awaiting! :) I guess I should try to keep busy and keep my mind occupied...so much easier said than done. Good luck praying you have your answer first thing Monday!!

Because I am impatient, I called Cigna and my case has been assigned to a nurse and I should have a status on Monday. ..here we go, a nerve wrecking weekend ahead.

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star21nd    34

star21nd
Posted

And of course my impatience got the best of me... I emailed my surgeons girl that handles the insurance part and she emailed me back fairly quickly that unforturantly she hasn't heard anything yet. She did say she would try to call Cigna and see if she could get an answer but my guess is probably not because it is Friday. :( Darn it!!! I should call Cigna but who do I call??

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star21nd    34

star21nd
Posted

Why the hell did I do that to myself...I called Cigna and was informed that I was DENIED once again even after the peer to peer!! I am so frusterated and angry...sitting here crying my eyes out. Im so pissed with Cigna been at this for 6 freaking months!!

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JacobsMommy    27

JacobsMommy
Posted

Why the hell did I do that to myself...I called Cigna and was informed that I was DENIED once again even after the peer to peer!! I am so frusterated and angry...sitting here crying my eyes out. Im so pissed with Cigna been at this for 6 freaking months!!

Omg I am so sorry to hear that. ..wow, did they say why?? Wow, my heart aches for you. Now I'm really a basket of nerves. ..

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star21nd    34

star21nd
Posted

They couldn't tell me why! Like always wait for a letter to tell you why! I did email my surgeons lady at the office and told her what I had done by calling them and she called me just a little bit ago and said she called them as well. She said they told her it was denied too, she just couldn't believe that it would be. She's hoping that they are looking at the first denial from back in Jan. but I told her they told me they saw it was reopened April 30th and still denied! She is hoping that because it went straight to medical director that it just not showing in the system. The medical director has until Tuesday to get a answer(that will be his 1 week) if they could a week like us "normal" people..lol. So now I wait for a freakin piece of paper in the mail and if denied we Appeal!! I will not give up but doesn't mean that its not frusterating as hell! :)

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Jersrose43    837

Jersrose43
Posted

OMG my husband tells me I am the most impatient person in the whole world...I want to call too but I have no idea who to call. I have never called Cigna. Maybe ill email the girl who summited the claim. It is going to be a long weekend awaiting! :) I guess I should try to keep busy and keep my mind occupied...so much easier said than done. Good luck praying you have your answer first thing Monday!!

Call 1-888-92-Cigna

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JacobsMommy    27

JacobsMommy
Posted

They couldn't tell me why! Like always wait for a letter to tell you why! I did email my surgeons lady at the office and told her what I had done by calling them and she called me just a little bit ago and said she called them as well. She said they told her it was denied too, she just couldn't believe that it would be. She's hoping that they are looking at the first denial from back in Jan. but I told her they told me they saw it was reopened April 30th and still denied! She is hoping that because it went straight to medical director that it just not showing in the system. The medical director has until Tuesday to get a answer(that will be his 1 week) if they could a week like us "normal" people..lol. So now I wait for a freakin piece of paper in the mail and if denied we Appeal!! I will not give up but doesn't mean that its not frusterating as hell! :)

But why we're you denied before? ? That's crazy. ..i admire your tenacious and positive attitude! It will work out for you

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star21nd    34

star21nd
Posted

I was denied back in January after my first 3 months of diet classes because they didn't want to use those classes, they wanted it to be more medical supervised so Ive spent the last 3 months in a specialized diet class that is just for people doing the diet for wls. The only reason i have kept being denied was because they said i didn't have this paperwork or that paperwork, which has been faxed to them so many times.. Im praying it's something so stupid and little that is easily fixed but i think its a stalling process because how can not you get all the paperwork when it's been faxed to you millions of time. I don't know why denied this time because they wouldn't tell me, said i have to wait for a letter from them in the mail!

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star21nd    34

star21nd
Posted

JacobsMommy, did you ever hear anything?? I just got the call from my surgeons office that I have been APPROVED and I have a surgery date of June 18th so I guess those fools at cigna lied to me about it being denied again after peer to peer. If you get denied I would ask for a peer to peer! Best of luck to all still fighting and waiting for their surgeries to get approved..continued prayers!

Because I am impatient, I called Cigna and my case has been assigned to a nurse and I should have a status on Monday. ..here we go, a nerve wrecking weekend ahead.

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Luckyinluv    30

Luckyinluv
Posted

Cigna said all they needed was a medical clearance letter so we faxed it to them and my surgeon said we may not hear from them for two weeks! Well guess what??? I am going to call everyday!!! If they only need one paper then I don't think it should take two weeks!

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