Cigna Questions- Help!

Hi everyone, I am just starting to gather everything to send in to Cigna for my first attempt. However, before I do that, I have a few questions... Did anyone appeal and recieve approval after a rejection stating that they didn't have enough diets history? How did you go about this? Did anyone contact a lawyer? Did this help? I am trying to prepare for the worst, as I know that I am very likely to be rejected since I've not been under a doctor supervised diet. However I was recently on Jenny Craig and have been on tons of diets before, just not by a doctor. Are there any recommendations that you can give? Also, how long is the appeal window? Thank you for any and all advice! Kate Underwood Boynton Beach, Florida

Hello Kate. I just won my appeal with CIGNA. Its a daunting task. Take control of everything. Get those reports from Jenny Craid and have their offical sign them. Next bring them to your Primary Care Doctor and request that he enter them in his notes. YOU CAN REQUEST IT! He should make notation in his records. Get all previous diet histories as far as you can go back. I went back 6 years. Carefully detail weight loss and boomarag weight gains by month throughout this period if you can. Secure all PCP medical notes..even the ones that are not about weight. Get all notes from any other specialist you have seen in the past 1 to 10 years if you can. The more information that you can provide; CIGNA will get better picture of you health conditions. If you are an informed client....Ask your surgeon's office if you can view the packet that they will be sumitting on your behalf. Then you check it for accuracey. Do not leave anything to chance. Don't assume the mind set that they are suppose to do it for you. This Journey is about YOU! Also in my appeal, I contacted CIGNA promptly within 2 weeks with those appeal letters from myself and PCP as well as the American Disabilities Act as this forum suggest. I made a call to the attorneys at Obesity Advocate.com and Cc. them in my appeal I BELIEVE IN YOU KATE. MAKE IT HAPPEN. I pray that things will go your way. But you are so right to plan you backup approach now. Let me know how it goes. Good Luck.

Hi Kate, When I started my process for the by-pass I called Cigna and they stated that Weigh****chers was a "supervised" weight loss program. five months later when I went through all of the hoops and was ready to submit the paper work, the "referal associate" Veronica, at my doctor's office told me that Cigna just turned down 4 claims this week because now Weigh****chers was not a supervised weight loss program. I asked Veronica to hold my file, took my weigh****chers chart into the doctor and they added it to my chart. If you have a good relationship with your primary and they know and support your desicion speak to them about it. Once I had that I faxed it to Veronica and then she submitted the paperwork. I was approved on the first try. Good Luck and Keep me Posted

My surgeon filed my insurance Thurs. 11/19/03 and I have called them on that thurs. and fri. and management in my office is going to call them on Monday the 23rd to see if she can pull any strings as Cigna is no longer covering this surgery after the first of the year. We were also told that if the surgery is not done by the end of year it will by no means be covered. I contacted Cigna back in Aug. to make sure they even cover the surgery before I got my hopes up and they assured me they do. I will let you know what happens next week as I hope to have an answer, I have alot of people pulling for me on this so we shall see. I believe if they deny me then I would have a lawsuit but I wont go that far till it is necessary. My surgeon says as soon as the approval goes through he will bump me up if he has to to make sure it is done by end of this year, he is a wonderful surgeon. He says I may be able to have it as soon as the first week in Dec. which is almost here so cross your fingers and say a prayer for me please. ;o)