please give advice on Cigna

sweetiesmom
on 6/5/08 5:51 am
 Hello-from Arkansas.I have been on before but no one answered.I hope someone can tell me if they have been through this before.I started my journey for the lap-band last fall. Cigna needed more info and my doctors nurse refaxed every thing without my needed papers thinking they never received the first ones,tried to explain this mistake and faxed the new papers they needed but they called it my first appeal ,but it was not  suppose to be,any way  now I am on 2nd appeal--I have arthritis and have been disabled with it for 14 years also  fibromyalgia,high b p,high collesteral and osteoporosis in my knees.Which none of these were enough ,anyway long story short they said the first time I showed a 40 bmi was in August of last year and that I had 180 days from March 4 to do 2nd appeal and I am planning on  waiting till the end of July and appeal because it will be a year of a 40bmi and I hope this works because if I have to start over they now want 2 years of a 40bmi or that is what I have heard but because I had already started I just have to have one year.Any one have  any feed back on this?--And sorry about my writing skills. P.S.how many appeals can you have?
ValB
on 6/7/08 4:24 pm
If you have documented High Blood pressure and your BMI has been 35 and above that should be sufficient for Cigna.   I had Cigna and was denied the first time due to 6 month diet info - but it was only because they made the decision before they had all the paperwork.  I sent them the diet stuff and it was approved and i had surgery like a week later!  Someone posted about intracorp on one of the Cigna questions - call t hat number - they may be able to tell you  more detailed information. They did just change their policy on bariatric surgery effective 5/15/08 - they will tell you that it applies immediately regardless of when you started - but we are fightng this also for my husband.   Having your surgeon due a peer to peer with the dr at cigna that denied it may get it overturned for you.  Call you surgeon's office and ask them to do this for you.  Good Luck!  Valerie 

band 4/18/08 slipped band 10/15/09.  further band complications --revision from band to sleeve 10/21/10.  Starting Weight - 230 Rev. surg wt - 203 Current - 147 Goal - 130

          

  

gary viscio
on 6/10/08 11:40 pm - Oceanside, NY
RNY on 07/01/03 with
with the right documentation CIGNA should cave after the second appeal best of luck
Gary Viscio
www.ObesityLawyers.Com
RNY 7/1/03  -166lbs
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