Help with CIGNA

I rec'd my denial letter from Cigna today and I was turned down because I had not completed a six month supervised diet program. I have met all the other criteria except this.It didn't matter that I had been and weighed in with my personal physician every 3 months for the past four years. Has anyone got any idea how to get approval from Cigna without waiting another six months and wasting more time and money ?

Brad, I have Cigna & I got denied my first time because of the 6 month supervised weight loss history, don't give up, I went to my PCP & we went back 2 months and then I had to wait 4 more months. I tryed EVERYTHING possible to avoid the wait but it didn't work, I was at this time in 2nd level appeal, I finished my 4 months of going in every month & weighing & talking to my PCP about weight & exercise, make sure if you do this that your Dr. makes documentation of everything you talk about, Cigna said we even had to discuss exercise & everything but I did it & sent it in & got a call saying they wanted me to have a tele-conference with a Dr. from Cigna & the members of the board, so we set that up & it was simple, they sent me a letter with a certain time to call I had to call at the exact time to be connected to the room with all the board members & Dr. We all talked, they had me on speaker so everyone could hear, I had to tell why I felt like I needed this surgery & all my health problems, after I got finished each member had a chance to ask me questions but not the 1st person had any questions for me, they said thank you & that I would hear something within 30 days, so my call was at 2:00p.m, when we disconnected I waited 4 hours & called back I was just gonna take a chance that they had already made a decision & a lady put me on hold & got my file & said I was approved immediately, the same day. I was so happy, but trust me Cigna will put you through alot to get approval. Don't give up, you can beat them. I'll be happy to talk with you anytime. It took me about 8 months to get approved. Good Luck , fight fight fight Tammy

Hi Tammy, Thanks for the reply. Sounds like I am going to have to wait another six months regardless. Hopefully my Dr will back it up 2 months like yours did.Tell me, was your PCP in on the tele-conference call or just Cigna and the board? Also, do you think it will do me a bit of good to go ahead and file the appeal or just do the 6 mos thing and re-submit. Thanks again for the advice. Brad

My PCP was not in on the canference call, just me, a Dr. from Cigna & their board members, it wasn't bad I think it lasted about 20 minutes. As soon as we got off the phone they made my decision. I was on 4 blood pressure pills a day plus other med. What you need to do is go to your PCP & see if their is any way they can go back 2 or maybe even 3 months, then you wouldn't have many more to go. I would file the appeal, you get 2 appeals so you will have 1 left, you never know you might be able to work around it, I couldn't though. I had my I had my phone conference at 2:00p.m on 3/29/05 & I found out I was approved that afternoon, I had surgery on 5/2/05, that morning I weighed 261 & I am 5'2, today I weigh 198 & I feel so much better. I was determined to beat Cigna, my son is in middle school & last year he came home from school & I could tell something was wrong so I went to his room to talk to him & he started crying telling me that a boy at school started making jokes to him about his mama that looks like a whale, that made me so mad & broke my heart to, & this year I am gonna make sure that kid see's me & how much better I look. I told my son some kids are just mean. If I can help you in any way just let me know. Good Luck! Tammy

Hi Brad, sorry to hear that Cigna's running their game on you. I,too have Cigna and it took almost a year to get approval for my surgery. It took a first level appeal to get my approval. There is a Yahoo group called Cignassqueakywheels that is a greast source of info. conerning with Cigna and it's requirements, perhaps you should look into joining them. I joined and found great support there. Best of luck to you on your quest. James

James you really need to update that pict! lol. I just know someone took a stellar wedding picture you can use Kia 284/202/155

I dont have cigna, but I did just finish my 6 month dietician THING. I had to be meet with the dietician 3xs month and be weighed each visit, set up a diet plan, and see my pcp on the week I did not see the dietician for 6 months. I am so sorry that they did this at the last minute, but honestly I have been there. I was so upset. It went by pretty quickly, God Bless and good luck.