X-post Appeal
Has anyone ever appealed to Cigna and won? I have a Realize Band and had to have an emergency unfill in December. Since then I have had a lot of acid and heartburn. My doctor sent me over for an upper GI and my band is in perfect position. I haven't lost ANY weight since April of 2011. The last few months have been fill to be unfilled the following month. This is frustration, I am hoping to revise to the sleeve.
I would appreciate any help offered.
Thanks
Andrea
HW 300, SW (Realize Band) 268, Revision to VSG 264
I don't have much experience with Cigna, but what was the reason for the denial?
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
Which there isn't. It's everything else thats seems to be wrong.Apparently their denial is typical on first-time requests like these. Here is a link to an attorney (advocacy group?) that did a 2nd level appeal to Cigna and the revision was approved. This was a while ago, but I imagine that the principles are the same.
http://wlsappeals.com/bariatric-insurance-denial-revision-ap peal/
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
I have hired them to help with my appeal. They contacted me with some followup questions and a plan of action within 24 hours of my submitting my info to them. This is miles beyond the service I got with the doctor's insurance coordinator. I believe they offer free consultations; it might be worth talking to them?
Sleeved 6/12/13 - 100 pounds lost to get to goal!
Hockeymom87 · 0 replies · 611 views
