Cigna Denial Questions
I was recently denied surgery after overwhelming accurate recording. Cigna said it was not medicaly necessary and was not in my policy. There is no mention of it in my policy. I have contacted the Lindermans of Obesity Advocatcey Group. Has anyone used them before? They apparently have different levels of help that have corresponding prices. Cigna says I have 30 days to appeal. What happens if I miss the 30 day window. How should I proceed further. What should I do in the mean time as my surgeon and PCP write appeal letters for me to give to the Lindermans. I feel like I need to be doing more before the issue dies down.
Alicia, They said according to my Cigna POS policy that it was not medically necessay and not covered in my policy. There is no direct statement that says itis not. It does include medically necessay surgeries. All of my doctors and specialist say overwhelmingly it is needed. My BMI is 55. I my apeal letters from my PCP and Surgeons today and Psychiatric Eval copy today. I will be sending the my information to the Obesity Advocates this week. I'm not giving up through. I have contacted many and request letters of support. I'ts On Now!
Phi yoba, did you pcp and surgeon say it wasnt medically necessary? If they did not then Cigna cannot deny you.It will proably take an appeal or two but you will make it through. I am using an attourney to do my appeal and he said most likely they will aprove it at the end. Here goes my Journey.
Alicia
Anita R.
on 10/2/03 11:40 pm
on 10/2/03 11:40 pm
Phi -
I am sorry to hear of your denial. All I can say is - follow what the appeal letter states to the tee to avoid further complications. In my opinion if this is medically necessary then you should fight this until it is approved! It may take some time, but keep the positive attitude and remember this is YOUR LIFE! Light the fire under Cigna
I was denied by Cigna also for not having enough weight loss attempts. I appealed and won. You need to have you PCP write a letter of medically necessary and you send a letter also.. I would appeal. I had two chances with the appeal process. You can find out and try the first one by yourself and then use an atty for the next appeal if they deny you.
Good Luck
Sharon
Alicia, Anita, and Sharon, thank all of you for your imput. IT REALLY HELPS!. My PCP said if anyone needed it ...that it was me. He wrote me an appeal letter but I told him not to send it because I was putting it in an appeal with the Walter and Kelly Linderman. Maybe Il"ll send in his with my appeal before I spend much more money.Cigna said that under the terms of my POS policy, that it was not covered and not medically necessary when no less than 7 other specialist say it is. There is no mention in my policey at all.