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Cigna approved...but not everything

kyrickchick64

By kyrickchick64, in Insurance & Financing

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kyrickchick64    468

kyrickchick64
Posted (edited)

Well I was approved by Cigna in 9 days after the doctor filed it. They say nothing about the hernia that my doctor says I have and wants to remove. Of course my life happens and I cant have it done till this month. I had to go to my best friends mom funeral and stay with her since the day before Christmas then her sister had a heart attack. Wasnt meant to be for 2014 but I'm ready to kick 2015's ass. Extra co pays deductibles or not!

Edited by kyrickchick64

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kyrickchick64    468

kyrickchick64
Posted

Well I was approved by Cigna in 9 days after the doctor filed it. They say nothing about the hernia that my doctor says I have and wants to remove. Of course my life happens and I cant have it done till this month. I had to go to my best friends mom funeral and stay with her since the day before Christmas then her sister had a heart attack. Wasnt meant to be for 2014 but I'm ready to kick 2015's ass. Extra co pays deductibles or not!

I'll be on the doctor and insurance tomorrow about the hernia

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LSF    264

LSF
Posted

You are lucky they approved you so quickly.

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kyrickchick64    468

kyrickchick64
Posted (edited)

It's been a long road but as far as getting it signed off on was fairly quick. I jumped thru a ton of hoops to get there. @ Jenniferg2013 I was told its just a code error. I've had 2 other hernia ops and they've always paid. This sucker is starting to give me problems so it's got to go. I had one during my hysterectomy and then I had one let go one day out of the blue. I never threw up so much in my life and recovery was a bi#ch.

Edited by kyrickchick64

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BLERDgirl    6,417

BLERDgirl
Posted

Sound like you are a good friend. I'm happy to hear you got your approvals straightened out.

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LSF    264

LSF
Posted

I was denied today!! I called to find out why and they said it's because the hospital does not qualify with Cigna for Bariatric Surgery so now we have to re-submit to see if they will approve it. My surgeons office said they always have problems with Cigna

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Jersrose43    837

Jersrose43
Posted

Most insurances pay the hospital for the EVENT

surgeries are payable in a different way to surgeons.

You get the first procedure authorized - sleeve etc

The hernia is a secondary procedure. The insurance may pay for it or may deny it as inclusive to primary insurance.

Either way the patient is not responsible and it's a loss to the doctor.

As long as the procedure you want is clearly stated on auth - the sleeve. You're fine and good to go

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Jersrose43    837

Jersrose43
Posted

I was denied today!! I called to find out why and they said it's because the hospital does not qualify with Cigna for Bariatric Surgery so now we have to re-submit to see if they will approve it. My surgeons office said they always have problems with Cigna

See my pm.

This shouldn't be a problem. If it wasn't brought up before am surprised but perhaps your coverage changed on 1/1/15? This is not the type of change that an employer is required to notify you of

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mrsmith901    18

mrsmith901
Posted

This all makes me nervous! I am waiting on approval from Cigna right now. They told me they have 30 days to let me know. So nerve wrecking!

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Jersrose43    837

Jersrose43
Posted

This all makes me nervous! I am waiting on approval from Cigna right now. They told me they have 30 days to let me know. So nerve wrecking!

Actual time is more like 7-10 business days. Call and make sure they have the auth request and then call every few days to check a status

You will know before the doc

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mrsmith901    18

mrsmith901
Posted

Actual time is more like 7-10 business days. Call and make sure they have the auth request and then call every few days to check a status

You will know before the doc

Thankfully it only took 5 business days! You are right, now I have to wait for the surgeon's office to get a copy of it.

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LSF    264

LSF
Posted

Did you get a date?

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mrsmith901    18

mrsmith901
Posted

Not yet! Waiting on the surgeon's office to get the approval now.

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Jersrose43    837

Jersrose43
Posted

Keep nagging the surgeon. They get pounds of mail everyday

I forced mine to call them. Then I got the letter and faxed it over

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Go To Topic Listing Insurance & Financing

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      1. summerseeker

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        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.

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