shbp members you aint gonna believe this sh*t

LaShelle2
on 8/6/09 5:02 am - STOCKBRIDGE, GA
I JUST CHECKED MY CLAIMS ON MYCIGNA.COM.

IT SEEMS THEY DENIED THE CLAIM FOR MY SURGERY

THERE IS A NOTE  SAYING TREATMENT FOR OBESITY AND WEIGHT LOSS SURGERY IS NOT COVERED BY YOUR PLAN...


THIS IS HILARIOUS. YOU'D THINK AFTER ALL WE'VE BEEN THROUGH THEY WOULD GET IT RIGHT BY NOW.

I AM SWITCHING TO UHC IN NOVEMBER

I CANT TAKE THIS SH*T ANYMORE!!!!

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

stromatt8163
on 8/6/09 6:20 am

I'm so sorry to hear that.  So you had your surgery in July and they are just now telling you that your claim has been denied?  If you don't mind me asking, what type of plan did you have under Cigna?  I'll be praying for you.

LaShelle2
on 8/6/09 6:28 am - STOCKBRIDGE, GA
I am a state of GA employee. It's the Cigns shbp HRA plan.  The surgery is covered.  I have the benefits.  They just screwed up in claims.

We shbp members went through a lot to get our wls approvals.  The drama w/ Cigna started in January. 

I am peeved that after all we've been through they're still screwing stuff up.

They corrected the claim today after a 45 minute call w/ Cigna. I just shouldn't have to go through all this to get them to do what they should have done right in the 1st place.
stromatt8163
on 8/6/09 6:48 am
No, you shouldn't have to go through all that, especially knowing that you are under some stress right now just a few days out of surgery. 

But I am glad to hear that you go it corrected.  Thank goodness!  Take care.
olliebobs
on 8/6/09 7:07 am
That is so crazy!  Sorry about the stress.  Good thing you are always on top of everything!
lrod1329
on 8/6/09 8:08 am
I cannot believe that!  I am reading this and just shaking my head.  Do you think the doc's office just coded it wrong?  You don't need the stress, but I am glad you got it taken care of.
Take care,
Lisa
LaShelle2
on 8/6/09 8:52 am - STOCKBRIDGE, GA
No, it's just Cigna.    I spoke with a supervisor (from experience I have learned just to skip the reps).

She said she would get it done in 24-48 hours and call me back.   I told her that was
unacceptable. I want it done NOW!

She put me on hold and 15 seconds later it was done.

Now why did I have to be a ***** for her to do it when she coulda just done it when I 1st called???
Keek77
on 8/10/09 7:05 am - Rome, GA
LOL this is too funny.. I skip the reps too b/c they don't know what the hell they are talking about....


My new problem is with the pharmacies that don't want to call and get the right information... I've met my out of pocket max for this year.. I should not have to pay ANYTHING... and they don't wanna call and get the right information..

This ins. crap is sooo annoying...
LaShelle2
on 8/10/09 10:31 am - STOCKBRIDGE, GA
I get the same thing. They look at me funny when the total ocmes to $0 like I'm scamming them or something.    I guess not many people have HRA plans.

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

Ginger L.
on 8/10/09 12:19 am - Woodstock, GA
Girl... Havent you learned that INS people never get it right!! LOL   Im sooo glad your doing well!!!  Cant wait to see you again!  
Hugs.




Starting Weight: 325;  Pre Surgery Weight: 314

 

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