Cigna denied.

[kdtaylor 0]

Received my call today saying Cigna (great west) denied. I finished the 3 month weigh-ins and all my drs appointments. The coordinator told me they denied bc cigna requires 3 months that total 89 days and they sent my papers in too early. So now I have to go back in for another weigh in and they will send a second time. Anyone else have this happen? Should I be worried that they have to submit it again?? Thanks!

[msIva8 1]

I have Cigna. And they denied me because my doctor wrote my letter of necessity on prescription paper. It HAD to be in the exact format they wanted. I had to resubmit the letter. By that time, I had to redo my labs, ekg, and X-rays. Took me seven months. Had my surgery on the 26th of last month. Cigna is picky. Hang in there.

[goodnuff 239]

Cigna here too, I got a first letter of denial too, basically all of the t's weren't crossed. I was approved within 2 weeks. Don't worry about it, they are very picky about the appointments needing to be 30 days apart. I have no doubt that once you meet that requirement all will be a go.

[4MRB4PHOTO 3,899]

CIGNA denied me too, I received the letter the letter on a weekend 2 weeks before the scheduled surgery

on the basis of I was not on a medically supervised diet for at least 3 months and my PCP did not state it was medically necessary, even though she did submit the paperwork stating it was.

They were paying for all of the pre-op medical services including meeting with a nutritionist 3 times (~5 months since the first visit, at that point).

Phone calls from my surgeon & PCP's office squared it away.

I have had other medical providers, for me, CIGNA has been the worse so far for denying claims.

Edited June 20, 2015 by 4MRB4PHOTO

[AllthingsApple 34]

My packet was submitted to Cigna yesterday and I'm hoping there are no issues and that my PCP's letter of recommendation/necessity is sufficient...it seemed somewhat general to me but my case manager sent it through. Fingers, toes, and eyes crossed ????. I'm planning on calling today just to ensure they received it and then bugging the heck out of them since they make us jump through so many hoops.

[AllthingsApple 34]

UPDATE: I was denied by Cigna.

The reason..."the Doctor needs to provide more clinical notes". When asked what EXACTLY was needed in these clinical notes, it he rep said,"well I don't have access to the pre-certification database but they will send a letter to the Dr".

Disheartening to be made to jump through all of these hoops AND continuously be down in weight at each required visit just to be told we need more notes.

****If you have Cigna be sure you have this exact language in your Primary Care Physician's letter or you will be denied:

" {Enter your name} has been recommended and cleared for Bariatric surgery from a primary care standpoint."

Edited July 1, 2015 by AllthingsApple

[goodnuff 239]

I feel so fortunate that the insurance coordinator at my office sent a letter that indicated in no uncertain terms exactly what Cigna required, including how it needed to be worded to get approved. Good luck to anyone jumping through those hoops right now.

[KDM74 186]

Received my call today saying Cigna (great west) denied. I finished the 3 month weigh-ins and all my drs appointments. The coordinator told me they denied bc cigna requires 3 months that total 89 days and they sent my papers in too early. So now I have to go back in for another weigh in and they will send a second time. Anyone else have this happen? Should I be worried that they have to submit it again?? Thanks!

The exact same thing happened to me. I went for my 4th visit and was approved right away.

[kdtaylor 0]

They had me come back in and resubmitted to insurance the next day and had my approval that afternoon!

[smkallen67 31]

My docs office submitted almost 2 weeks ago and today Cigna said they didn't have all the info they needed and was going to deny when everything they said was missing WAS submitted. The nurse is resubmitting today what was missing and hoping for approval. Just BS that they say stuff is missing when it's their in front of them to hold up the process. Very frustrated. Wanted to hear accepted this week since I did all I was suppose to and all was submitted. UGGGH! No guarantees I understand even if you meet all the qualifications. Just have to pray and be patient something I am not very good at.

Sue

[kdtaylor 0]

I'm not good at being patient either! Good luck!

[Jersrose43 837]

I have Cigna and I work there.

My insurance coordinator told me she submitted everything. So I asked - what exactly ? Bullet point it for me as I already knew I had been senied. I called every single day.

She failed to send the letter from the pcp. And I knew she was lying that she had sent it. My pcp didn't even write it until the week AFTER she sent in my paperwork. Her mom had a stroke and she left the letter unsigned on her desk.

When she got back she signed and sent me a copy and the surgeon.

I was so pissed. It required an appeal at that point and a peer to peer.

So don't always blame the carrier.

When she called me back that it was approved I told her I knew that already Cigna sent me a letter 8 days before she called!

Needless to say my surgeon heard all about it. She was the reason I was ready to go in April but didn't have surgery until June 24 !

[caligul 102]

It must depend on your surgical teams staff....I have Cigna and everything went fine. ..

[smkallen67 31]

Almost same thing happened to me. It was due to the submitter who repeatedly left information out that was there adn got denied twice. I got supervisor involved to found the info and set up a peer to peer which got me approved, that God. Sent a letter to her bosses boss who responded right away. doctor couldn't apologize enough and all is good scheduled for 31st of july. they are suppose to be your advocates and she did not her job properly either to being under trained or over worked. my yelling and screaming did get me somewhere though. Good luck to you!

Sue

[nikkimapr 177]

The surgeons office and pre approval lady at my surgeons office have done so many they have it down to a science. They also send a packet to my PCP with everything line by line they have to do. I tried to get them to push my last appt up a day or two but they said no it will cause cigna to deny if not over 3 months. So sorry everyone having problems. Thus is where the doctors office can really help alot since they know what these insurance companies look for