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CIGNA people-How long did it take for approval/denial?

I have CIGNA. My paperwork was submitted April 19. There is still no word. The doctor's office said they had 30 days but usually when they deny it's within the first week or two. I'm interested in knowing if you were denied, how long before you got that word, and if you were approved, how long for that? My surgery is scheduled 5-23 and we're getting down to the wire here....:)

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I faxed my paperwork to the surgeon's office on February 11th (paid 23 bucks to do it by UPS) and got a letter from Cigna saying they received my paperwork on March 28! A week later they denied my claim.

Well after 18 months of struggle and getting an attorney involved I finally have been approved for the Lap Band as of Tuesday morning.

I was scheduled for a mediation meeting with Cigna and my attorneys office for that morning but got a call first thing that day and was told that they had cancelled the meeting because they had decided to go ahead and approve me.

Unbelieveable, since there was not a think that I had changed from the first time I was denied it just goes to prove that the first 3 denials were something they just do automatically hoping you go away.

If any of you are fighting a denial I cant stress to you how important it could be for you to contact ObesityLaw.com, I would never have been approved without thier help.

Janine

If any of you are fighting a denial I cant stress to you how important it could be for you to contact ObesityLaw.com, I would never have been approved without thier help.

Janine

Congratulations Janine...it's always good to hear a story like this! Good for you for not giving up! May I ask you for some help. I am just so tired of spending 1000s of dollors on this whole process and countless hours of my time just to be rejected. I am afraid to lay out any more money on this.

Could you please help me with the following questions. I would be most grateful.

` What was your BMI?

` Did you have co mobidities?

` How much did the attorney's charge you each time?

` I was rejected due to a BMI not being 40 for a year or more. It was a 38 at the time.

If my BMI is 40 NOW (which it just became) and I start the process all over again will my visits to the Phych, Nutritionist, Surgen still be good after over a year? They told me I had to have a BMI of 40 for a year and they didn't approve my non life threatening comobidities due to meds help. Well I can start the clock now but go through all that again!!??

I guess I'm wondering at what point is it worth fighting them. Should a wait a year or two where I will totally be a 40BMI with some co morbidities for them too. Will they reject me because I tried to apply before?

In my case, my BMI is 45 with comorbidities.

I had previously filed an insurance complaint about Cigna regarding a short-term disability issue. I don't know if that had anything to do with them being so nice to me?

My doctor's office was adamant that we not send in the paperwork until we have every last "t" crossed and "i" dotted. It took seven months (which seemed like forever) but it worked.

Don't give up!

My Bmi is about 50 and I have sleep apnea and am recently diabetic, I also have PCOS and low Thyroid so met all the requirements in that regard.

I didnt have to pay anything for the attorney because I called Allergan/Inamed the makers of the Lap Band and talked to thier advocacy group and was accepted by thier group, they work with the Lindstroms at Obesitylaw.com and because I was accepted by them there wasnt any cost to me.

The first thing you should decide do you want to wait it out and try and gain the extra weight (I waited for approval and in that time became full blown diabetic) or do you want to see if you can get approved another way.

Go to Obesitylaw.com and fill out thier questionaire, if they feel you have a case they will refer you to Allergan.

Also one thing I have heard is that quite a few people had thier height listed incorrectly and were actually shorter than they thought they were, when thier BMI was recalculated with the correct height thier BMI was higher and they then qualified.

Might be worth being measured by your doctor again and using your worst posture LOL.

Janine

I don't think Cigna will accept Weight Watchers. I also wonder how people got approved using that. I just wonder if the surgeon's office 'fixes' the records to make them look like they were doctor supervised.

I am having problems getting approved. I was denied on April 16 because they needed a letter of medical necessity. A rep from Cigna indicated that was all they needed. I pray that I can get an appeal going quickly. I hate this waiting game!

I got a denial letter for lack of 6 month diet and then I called to see exactly what I needed for the documentation. I was ready to begin the process all over again. When they got to my authorizations, low and behold, I had an authorization number. It had been over-ruled by a letter and 6 more pages of documentation the surgeon's office had sent! :scared2::lol::lol:I am so excited. I can't wait to get a surgery date! It will be sometime very soon! :tongue2::rolleyes2:

  • 1 year later...

hey everyone! My doc submitted my paperwork to cigna on thursday, feb 18! I called yesterday and the rep said they have not even scanned anything into the system yet (which means they haven't even looked at it yet). I am super stressed because i live in Mississippi but i'm having the surgery done in Dallas, TX on March 15 because that is my spring break. My doc and I thought a month would be long enough to get approved. I have a flight leaving March 14, and my grandma is flying in to take care of me. They better get my stuff into the computer soon! I am going to call every single day until i am approved. I have no worries about actually getting approved, i just hope they hurry up and get it done so i can start my life over!

  • 3 weeks later...
I don't think Cigna will accept Weight Watchers. I also wonder how people got approved using that. I just wonder if the surgeon's office 'fixes' the records to make them look like they were doctor supervised.

They've recently updated the requirements, and as of last night they do accept Weight Watchers and Jenny Craig and stuff like that, as long as you are still meeting w/ a doctor every month.

Well I have gone through the 6 month process, doctors visits, psych eval and everything was turned in March 5. Was told by Dr. office that they have 30 business days but I really hope it is sooner. I would really like to have surgery April 19 and it has already been so long. :thumbup: Fingers crossed that the approval comes through soon.:smile2:

Well I have gone through the 6 month process, doctors visits, psych eval and everything was turned in March 5. Was told by Dr. office that they have 30 business days but I really hope it is sooner. I would really like to have surgery April 19 and it has already been so long. :tongue2: Fingers crossed that the approval comes through soon.:thumbup:

Call Cigna and ask for the pre-determination department and ask ask ask ask ask. Bother the heck out of them until they give you a satisfied answer. I spoke w/ Cigna today and they said it's only a week wait to find out if you're approved or denied. Never take no for an answer. :wub:

I also have Cigna :unsure:

My paper work was sent out on 3/11 and I called today and spoke to an associate and asked her if anything was showing up on the paperwork that was sent over last week. She said no, but would transfer me to a representative because "customers" couldn't be transferd to the Pre-Determination area..

The Rep told me that my paperwork had been received by them on the 16th and that I should hear something in two weeks.

Makes me so mad that other people I've spoke to at Cigna have said it takes 30-45 days.. :biggrin::lol:

I'm going to call next week and just make sure..and then another call at the two week mark.:tt2:

The only response I got from Cigna was that yes they had received my paperwork on March 5 and they had 30 business days to reply. I am going to call back again next week.

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