Cigna HMO Denied No Documention of nutritional consult.
Denied because there was no documention of nutritional consult. The requesting provider will need to submit the nutritional consult clinical. We have determined that the requested services do not meet the definition of medical necessity found in my benefit plan. I have called my PCP for a referral to a nutritionist. Has anyone been denied and then provided the consult and get approved??
Brenda, Its not over til its over. The same happened to me with CIGNA. Just hurry and appeal. Send your dietary history of every diet..supervised and or fad diet that you have been on. Then run and see a nutritionist. If you do this within thirty days of the reciept of the letter, it can be overturned. Get your PCP to write you an appeal letter on his letterhead and follow the guidelines closely on this forum for appeals. I was denied on 10/19 and approved on 11/5 and my surgery will be on Dec 11th. Good Luck! I kow you can do it.
This did my heart good to see and read. I am in the second appeal and this time the medically supervised diet went in with all of the other paper work including a second surgical opinion. My supervised diet was with a family nurse practitioner, which I hope will count. The second denial was because there was no medical supervised diet; we sent a letter from my doctor and one from the nurse practitioner for the first appeal. Now the nurse practitioner sent the weekly weigh ins for nine months. She saved my medical visits for her doctorial paper, thank goodness for small favors.
Long story short, we are waiting for the decision from CIGNA POS for the second appeal. Please pray for me.
Thanks,
KB
PCP to write you an appeal letter on his letterhead and follow the guidelines closely on this forum for appeals. I am not sure what you mean on a "forum for appeals" is that just sticking to the reason for denial? I left a message for Karen HeHer at sand lake for an appointment. With thanksgiving we have missed each other. Thanks for all your help!!!
Brenda