Now I am really Ticked off!!

Ok this afternoon call Cigna and talk to a girl named Erin who transferred me to a Matt Robinson in Intercorp who said my letter had been sent out either on the 10th or the 13th and it said that my documentation did not constitute medical necessity. Now I am really on the war path. That just ****** me off!! I have so many co-morbidities that you can't even imagine. He didn't say anything about the 26 week medically blah blah diet. He asked if I had spoken with my doctor and I said yes that Cigna won't even tell them what their stupid criteria are. I also told him that there are numerous websites stating how stupid Cigna is and how one hand doesn't know what the other is doing. That they are the laughing stock of the insurance world.l That they should catch up to the times that other insurance companies see this as a medical tool and save money in the long run when their patients are healthy and do not need to see a doctor all the time. ok I'm done now

GOD, sweetheart, I'm sorry. Respectfully, I'm no longer surprised by neither their STUPIDITY or their stall tactics, and that is EXACTLY what they are. Every time they can slow down YOUR chance of getting this surgery, it's sparing them that 24-$30,000 a little bit longer. Hell, I can't even get a COPY of my last denial letter to prove to me what basis they denied me for, when all I was NEEDING to do was complete my diet, per THEIR previous letter I rec'd in July!! All I can say is, I'm here for you to cry on, scream at, or vent with. I've had it, too. HUGS, ~Mich

Tamara, I am so sorry you are having a rough time with CIGNA. I keep reading that persistance pays off. Please, Please, go for an appeal. I am praying for you.

Okay, now I see ... you're a cigna victim. This is not to scare you. It's to make you feel less alone and make you understand that YOU CAN resolve this with them. They lie. They cheat. I sent in a package that was so completely beyond their requirements that Dr. B's office told me that they knew mine would be approved on the first pass. I had 246 weeks of documentation, broken up in 5 packages of periods way in excess of 26 weeks. Two of those were in the current year. Documentation of all comorbidities. EVERYTHING. About 400 pages in the documentation sent to them, and all of it in an indexed binder with a cover sheet. EVERYTHING was in it. So what did they do? Denied it the first time telling me I only had one 26-week weight loss program! Said I didn't lose 10% of my weight, and wrote a bunch of gibberish about NIH requirements that wasn't true. I appealed. What I should have done was appeal AND fax them a copy of my complaint to the regulatory agencies of Arizona, but I was being "reasonable." Hah! What did they do? They denied it this time for NEW reasons. They said I didn't have a psych eval (I had two). They said I had fibromyalgia and that surgery was contraindicated. (That's plainly a flat-out lie). I appealed. What I should have done was appeal AND fax them a copy of my complaint to the regulatory agencies of Arizona, but I was still being "reasonable." Hah! And then? They denied it again and told me I had to go to the external committee review. But THIS time, thanks to my angel, Michelle, and the other Squeakers, I had a list of things to do: 1) I filled out this frigging forms in spite of the fact that I'd been told I couldn't complain until after it was all over. I wrote a terse letter to cigna and faxed it to the person who sent the last ridiculous letter. I told her that I was weary from their exhaustive attempts to stonewall my surgery, and that I had reported them. I included the forms. 2) I wrote to the list of cigna dignitaries Michelle gave us at cignassqueakywheels.com. 15 minutes after I sent those Emails I got a call from the Executive Director of Policy Management who apologized profusely, gave my case to someone in North Carolina, who in turn looked into the file and discovered that the day before (the day I faxed them the forms) they magically approved my surgery. AND I got them, via his assistance, to type the letter that very day and fax it to my house. By 3:00 that afternoon I had a surgery date. So, Tamara, don't take this lying down. Just get up, and hand it all back to them! with loving support, Patti