Cigna

Who was the lady with the red hair who had so much trouble with Cigna? I am so sorry I cant remember your name. I really need help for a friend of mine trying to get approved by Cigna. If you see this or if anyone else on here has some advice please dont hesitate. He has been denied twice so far. The last letter says he has 5 days and only 1 apeal left. The problem is he wont have his 6 months Dr supervised diet in until June 16th, thats why they keep denying him. If he waits until then can he resubmit it all over? Or is he appeals and is denied again can he resubmit after the 16th? I had no clue what to tell him. I did tell him to call his surgeons office and ask the insurance girl for some help. His surgeon is Blackson. I would appreciate any and all help!! Thanks

oops I meant his surgeon is Blackstone

Hmmm, I believe I'M that red head...lol YES, I went throught HELL and back with Cigna. I was denied ALL 3 TIMES by them, and also by Hayes Plus, the external reviewer for BOGUS reasons, BUT...I got it overturned. They said (both Cigna AND Hayes) that I didn't have all 6 mo of weigh in's (I DID AND THEY HAD ALL MY WEIGH IN DATES!) and also that I didn't have my Psych eval ( I HAD TO HAVE IT BEFORE DR. B WOULD SEE ME!!) idiots!! I'm now almost 6 months post op and 60 pounds lighter with about 35 to go. (pfft, tell ME "no", will ya!!??) Be advised, per lawyer Gary V, they can NOT demand a 6 months diet out of you. It is a "guideline", NOT a rule!!! THEIR guideline! Check your appeal packet that you rec'd (or should have) with your first denial. I can't tell you the EXACT time frame that you have, off the top of my head right now, as I am at work, but I KNOW you have LONGER than 5 days to appeal! ALSO, you get 3 tries with them., and then off it goes to external review. Even then, don't give up!! Read my profile....start about in the Aug/Sept area of it, I think. Bottom line, DO NOT GIVE UP..!! I refused to..and every time I called them, I LITERALLY told them: " I AM NOT GIVING UP, NOR AM I GOING AWAY! I PLAYED BY YOUR RULES FOR 8 MONTHS, YOU WILL NOT DEPRIVE ME OF THIS" Another EXCELLENT group site is CIGNASQUEAKYWHEELS, through yahoo. You have to have a yahoo ID, but it's THAT easy. Write me if need be... Kindly, Michelle

Hi Michelle It was you!! Congrats on your weight loss you are doing great. I am now almost 9 months out and have lost 125. Not too shabby. Thanks for the help. I will forward all the info to my friend and also your profile,. If he needs anything else I will drop you a line. I feel really bad he is 475 lbs and has thyroid problems and I dont know what else. He has had such a hard time getting approved. For me it was so easy. I have Blue Cross Blue shield federal and was approved within days. Makes me feel bad for him. Thanks for all your help Sue

Hi Susan, Quite a few of us know what your friend is going through. Although I did not have nearly as much trouble as Michelle did. I was denied, sent my appeal in the following day and then got a call stating that I had been approved the day after they denied me. Cigna is a very strange group. Michelle is absolutely right about not giving up. Fight with everything ya got. The yahoo group has tons of information there in reference to appeals and even some really good appeal letters. Take care and tell your friend to fight fight fight. Tammy Lap RNY 1/8/04 326/240/135

Thanks Tamara for your reply. I will let him know to keep on fighting!! I will keep you posted! Sue