CIGNA INS

Cigna sent letter to my doctor and copy to me today saying they can't substantiate medical necessity for my gastric bypass which is tentatively scheduled for July 6th! They are requesting more documentation from my doctor. The letter goes on to say they aren't denying the surgery but it feels that way to me. Anyone else have these issues with Cigna? I have done the 6 months Dr. supervised diet and I had hoped they would put me on through. I am just wondering if you have dealt with this and how it went for you.

I don't have cigna but try not to get discouraged!  They haven't said no. Maybe your dr didn't submitt all they needed.  Also have you read their policies for bariatric surgery?  I know BCBS was very clear on when they would pay..

Kelly

Thanks for the encouragement. Several people posted some info about what I might need to do or look at. I appreciate your response.

It is not unusual for some of us to be denied at first.
Many times it really is over something very simple like added documentation.
Added test.
I was denied myself and it is like a kick in the face or felt like that.
You need to gather your wits and DO NOT GIVE UP.
Personally I had to stay on top of everything right down to having copies of everything.
In fact I wrote a letter along with my appeal about what life was like for a SMO person and hand delivered it.
I got approved two weeks later.
You just cant give up stay the course.
                                                                       Annie

Hi!

I have Cigna insurance and had several delays.   The last one was because my pcp didn't document the medical necessity.   There was an article in the Obesity Help magaine which had a sample of the letter Cigna was expecting from the pcp. 

Try this:

http://www.wlslifestyles.com/cached/_downloads/2096/Absolute s%20for%20Your%20Insurance%20Approval_main.pdf

Judy

Thanks so much for the encouragment and the link to the letter. I will take it to my pcp tomorrow. He did write a similar letter but maybe it wasn't detailed enough. I appreciate your response.

I'm with Cigna and I got the same letter. They were missing two pieces of information from my PCP (his letter recommending that this was the best course for me and documentation of my comorbidities). Once they received that information, I was approved.

I have CIGNA and keep your chin up - they didn't say NO. they just want every "i" dotted and "t" crossed so to speak. Stay on your Doc and make sure that his practice submits everything that CIGNA wants and it should go through with no problems.

Keep us posted.   - Iris

Thanks for the encouragement. I will march on and obey Cigna's dictates.

I have Cigna too. I got the same letter then about 4 days later I got my approval. They send that form out to everyone. Don't worry I know it is frustrating cause your soooo close.