DENIED!! PLEASE HELP

I have been denied by my insurance company, CIGNA.  Can anyone help me as to what I have to do to appeal, letters, etc.  I cannot get  a hold of my surgeons office to find out what information they sent CIGNA.  I am totally at a loss...I want to scream.... Please help. Thanks, Ines

Hi Ines. I can only imagine how frustrated you are! But you WILL fight this and you WILL win! Did they send you a letter yet? Did they give a reason for the denial?  We need to start with the reason and see what we can do about it. Had you read their criteria prior to submitting to them to make sure that you qualified for coverage by them?  There is a forum here on OH that helps with insurance issues... so that is one place to go. Hopefully when you get ahold of your surgeons office, they will have a better idea of why it was denied and know if there is something they can resubmit or you can take care of.  Don't panic yet..  it could be something simple. I know that my insruance company could not approve me because I had no medical record stating my weight for the year 2005.  I had not been to a doctor at all that year.  They told me that in lieu of a doctors recorded weight I could send them a dated photograph from that year. I found one and overnighted it to them and got my approval the next day. So it's not over yet! Stay positive and KNOW that you WILL  fight this AND WIN!

I was denied the first time.  My doctor wrote an appeal letter saying it was medically necessary and detremental to my health and well being if I did not have the surgery.  I think he used the words life threatening.  I also included records of weight loss attempts from the doc and from a local weigh****chers groupI was in. Don't give up, find out the reason and fight it !  Some ladies here have appeal letters on their profile. I'm sure they will post and tell you. blessings, Tami

I was going to say the exact thing!

Thanks you all for your encouragement.  It seems I was denied because I do not have a total of 6 months weight management and need a detailed letter from my PCP stating everything.  Since I missed 2 weigh in's, one in May and last month, due to my surgeon's office telling me that I would be having surgery in September, I did not bother to go to my PCP.  So, I will weigh in next week and then in October and I'm done.  Hopefully I will get approved then. Ines 

Hi Ines,

There is always - always - hope.

I worked with Kelley Lindstrom at obesitylaw.com. I highly recommend their advocacy services. They will look at your case potential and will not take your case on if they do not feel that you can win.

Look at the denial letter and ascertain the time limit that you have to appeal and act quickly.

HTH.