Denied

Got the news today and lost it... Dawn was not even nice or sympathetic... she said I don't know why you all get upset this happens quite often... I was offended that she has absolutely no sympathy for the people she deals with... I don't even trust that she didn't mess it up she got defensive right away saying I just sent what you provided... If she would have submitted more of the months maybe that would help. Oh well... I don't even have a good reason why. The details was sketchy... what now?

Did you submit six months of Doctor supervised documentation? Also, call Cigna they have to give you an exact reason for the denial. I was denied the first time, because I only gave them four months, then I provided six months and it was approved in less than 24 hours. Dawn was always good to me, this is not normal for her, maybe she was just having a bad day. Sorry that happened to you. Call Cigna tomorrow and find out their reason, this does not mean you are out. I have heard that some insurance companies make it a standard to deny the first time anyway. Keep your head up!! Shelia

Susan, is Dawn the one at Dr. Spaw's office that she would work with, or is there someone else? I have messed around with that same office and it is very frustrating... Melissa, perhaps you can get someone else there to help you... maybe ask for Bryan Woodward as he is quite knowledgeable in the insurance matters...

Just thought I'd let you know that Brian is no longer at Baptist. He had to go on medical leave due to his leukemia. He had a bone marrow transplant on February 28, 2007. He is currently living in an apartment near the hospital because he has to be within 15 minutes of the hospital for the first few months and he cannot be around his kids until his immune system gets stronger. Just keep him in your prayers that this will cure the cancer. Hopefully he will be able to return to work sometime in the future. Susan

Yes I gave them six and not they will not say specifically just to call Dr. and Dawn said have to wait for the letter.

Hi Melissa. I am sorry to hear that you were denied. I know the feeling. I was denied my first time submitting to Cigna too. I think that is normal for them! No really. I was denied because they required a 6 month Dr. supervised diet. I did not know this because it was not a requirement in my insurance plan but it is a Cigna personal requirement regardless of what the requirements in your companies personal plan are. Did you do this? If not, that is why you were denied. If you did, you will receive a letter from cigna saying why you were denied. You can call them also to find out. Whatever the reason is, you can do what they need from you to get approved (unless it was denied because it is excluded in your plan). Stay strong and keep the faith. It is not over. Just do what you have to and you can get approved. Keep us updated. Misty

The only thing you can do now is wait on the letter from the insurance company and then give them no reason to deny you again. If they want a six month diet proof then give it to them. Gather all your medical records no matter how insignificant. My personal way of getting approval was to drown them in paperwork so that they had to approve me lol. Good luck, Janie

Melissa, Take heart... I am a perfect example of being turned down (twice!) and then finally being approved!! I started out with that office, and felt brushed off, and basically "a number"... and I switched to Centennial. I've never looked back.. I am meeting with my surgeon next week and hopefully by the first of April I will have my surgery! The thing is this, you have to take ownership of your case! There is NO ONE who is gonna fight for you, except you! You are the customer, you call, you email, you fax.. whatever you have to do. I got records from every doctor that I have seen in the last 5 years... even for a cold.. I had documented weight and blood pressure. They turned me down first because of a policy exclusion - well that's where that office just quit on me! I called the insurance company and asked them if they had any exceptions to that, and was told that if it was deemed "medically necessary"... within that time I submitted all my info to the new office, an angel by the name of Lisa Ferrell started working with me, and thank the Lord above, today I can tell you I am approved! It takes tenacity, and just down right stubborness, but if this is really what you want, and you want this... you are worth the fight!!! I wish you all the best Melissa.. my prayers are with you.... I will be praying for you. Be blessed! Sonya

I can't go to Centennial... they are not in my network. I just think she should not have been so cold hearted about it. I am calling Cigna again in the morning. She would not send all my records to them she only sent for six months and I have been doing all I can on my end and I call and call and ask questions and ask what I need next but I am just tired of how I feel when I get her on the phone. The others are great but she acts bothered.

I am so sorry you had to go through this. I agree with Shelia, this is not normal behavior for Dawn. She is typically a sweetheart and very helpful. As for the denial, DO NOT GIVE UP!!!!! It is normal for insurance companies to deny the first request. Call the insurance company and ask them for exact details of why they denied and what they need. Don't wait for the letter of denial from them. I swear sometimes I think insurance companies have a certain number of approvals they give out and then they deny all the rest that day no matter what documentation they are given. Hold your head up Sweetie. This isn't over yet! Susan