Appeal to Insurance Commissioner...? Ugh!!!

this post is missing information, what was the reason for the denial?  medical necessity denial cases always have to have a written reason why the adverse determination.   this seems like 2 different issues...first it appears your vsg revision is medical necessity if you can show physical damage via radiological testing,  that should be covered, the reason you want to have the ds is unclear from your post?    the problem is insurance cos view vsg and ds as 2 different surgeries, even though the vsg is the first part of the ds. you have to separate the 2.   and what you, or your surgeons think about "wtf is cigna thinking" really has nothing to do with  coverage, that is based on your insurance policy.  if you get your insurance policy from work it is what your employer chooses to purchase for you. yes i have appealed to the insurance commissioner, what you have posted here, i don't see where that is applicable.... you need to know your adhesion contract well (subscriber agreement)