Totally Bummed!!!

Well Folks; I was denied on the 8th of this month for not having 26 weeks of medically supervised weight loss attempts. I did my weigh****chers and sent it in so I guess they are no longer accepting weigh****chers. So I made an appointment with my PCP to get more records together of the last 6 months, I know I have been there and weighed in at least once a month and we have talked about my weight loss on each of these occasions. Then it is off to the appeal process. Wish me luck.

Appeal, they denie you regardless of what you have the first time around. Everyone gets denied no matter what the medical reasons or weight loss attempts. Good luck, Tanya T

In July Cigna approved me with the 26 weeks Weigh****chers. I don't think they've changed their requirements (although I do think the requirements will change the fist of the year.) Did they say why you were denied?

I only talked to a lady named Pam at Cigna and she did not seem to be able to tell me. I have not received my letter as of yet. Hopefully that will shed some light on it for me. What all did you send from weigh****chers? I sent them my weigh in book. I do have my journal too.

All I sent was my weigh-in book. If you have your journal, you're ahead of the game. It will be interesting to see what your letter says. If it says something like, "Lack of evidence of weight loss attempts with less invasive methods," then one of two things is true. Either they've changed their requirements, or didn't recognize your documentation. If it is the latter, I'd call them up and call to their attention the oversight and perhaps you can nip this in the bud. If it is the former, I've heard that people have had success getting Cigna to pay by demanding that Cigna hold them to the requirements in place when they began the process. You probably already know this, but if you do call them, and the rep who answers the phone doesn't give you the help you need, firmly ask to speak to a supervisor. In my experience, the people who answer the phones are less than motivated, or less than empowered, to help.

WOW! ok cool thanks so much for the info. I just went and checked my mail and the letter still wasn't there so I am going to call them right now and ask where it is.

Weigh****chers IS TOO a valid form of a supervised diet!! They're smokin' CRACK or something. Wait for your letter to come, see how they phrased it, upon what basis you were denied, and then GO GET EM' ~Mich

Okay, Tamara! Here's where I spill! I don't know who your insurance company is. I didn't take the time to look it up. But it doesn't matter who it is. What matters is that you grab the bull by the horns, whip the sucker around and make it stand up. Get REAL rational REAL quick! Here's one thing you need to know: Your insurance company is not your friend. They don't care if you're nice. They don't care if you're mean. They don't care if you're emotional or dying. They care about keeping their money. They do NOT play by the rules. They will pretend they didn't get things they got. They will pretend that things don't meet approval which do. Your job is to be well informed and keep coming back to them with the truth. Your job is to play as hard and as mean as you legally can. So, you fill out the complaint forms with the regulatory agencies in this state (I have them if you need them) and you FAX a copy of them to the insurance company with a letter stating that you've turned them in for fraudulent and unethical business practices. We'll help you write this up in a cohesive, concise way... unemotional... just the facts. And you hammer them. You write/email/call every single insurance representative you can get your hands on. The higher up you go, the more cooperative they are. Tamara, YOU can DO this! Hang in there! with love, Patti