appeal vs resubmit???????????

ok.. for all that dotn know i was denied by cigna.. and in TWO montsh i have to make a decision about weith i resubmit or appeal? which do yall think i should do? and what does an appeal letter include? lexa

Didn't they deny you due to a lack of a medically surpervised diet (I might be wrong)??? What does your surgeon's office say? I would think they would know how you should handle the denial. If not, maybe someone here works in the insurance field or has been thru this already and has some advice for you. I know there are lots of examples of appeal letters out there, I think I might even have one saved on here somewhere. I'll look for it and send it to you if I can find it. Glad to see you are getting prepared for whichever insurance path you take. Amy

I was denied by Cigna as well. After getting all of the necessary approvals and having the diet documented, I was denied to the LapBand. The only surgery Cigna will pay for is RNY. So I appealed for the RNY. It was denied and I ask for a second level appeal. I finally had a teleconference with a doctor and 5 NP's. I stated my case and they approved it within 24 hours. Definitely get this surgery covered, if you don't and you have one problem, you are screwed. (Excuse the language)