DENIED and really Devastated, to say the least!!

 O.k... i am in tears as i type this, just got off the phone with Cigna Insurance, and i was told that my request for WLS has been DENIED!!!  Says MEDICAL NECESSITY HAS NOT BEEN MET??? I asked him to go into detail and explain, he just said the letter is in the mail...  I completed EVERYTHING that was asked of me!!!  6 months doctor monitor/approved diet, Nutritionist eval, Psych eval, BMI of 39 with Sleep Apnea, GERD, and lower back pain.  I am ready to start my APPEAL PROCESS, because not only do I want this, but I NEED THIS!!!  I guess they prefer you to be SUPER MORBID OBESE and health already at the END STAGES to be approved???  I am Hurt, and Devastated, so I'm taking the rest of the day off from work, because I just cant work right now, with all this on my mind.   Any help, or words of wisdom,  is really NEEDED right now... 

Keep fighting. Don't give up! ((hugs))

--gina

OMG - after you've gone through all that??  Don't give up - keep fighting and appealing.  It will happen... you may need to get your Dr's office involved.  I've heard if they write a letter stating your medical necessity that can work.

Rachael, I am SO SORRY to hear this...I really feel bad for you.  I am glad you are going to appeal this.  If the magic BMI for your insurance co is 40, gain a few lbs.  Good luck with appeals process.

Rachel,
Appeal, but wait for the denial letter and see what the reason is.  It may be something as simple as something not being turned in. 

I would get your surgeon's office involved to help you with this because they usually have so much more experience with the insurance companies. 
Did you call them?  They may already know the reason you were denied.

Did you get a written list of what was required to be approved?  If not, I would asked them for that in writing.

Good luck and keep us posted.
Linda

 Thanks everyone!!!  and Linda, yes, i got a list of EVERYTHING they needed, and I completed them with flying colors, and YES I even gained a few pounds... I have a feeling I will pack on a couple more pounds with the depression coming from this DENIAL...  it aint over until this PHAT LADY  sings, and I AINT SINGING YET!!!!    

Do not give up, babeeeeeeeee! Fight! Once you get the letter of denial, address each point they are making against you with support documentation from your doctors.

My mom was denied at first and with her PCP support, she was able to overturn the denial on the first appeal. Fight!

There is an insurance forum on OH that has a lot of knowledgeable people. You should post there once you get your letter of denial.

We'll be swinging lizards for you!

Appeal, appeal, appeal...lots of people get denied, but appeal and win! You are worth the fight!

I was were you are a few months ago.  Denied TWICE!!!  cried for weeks until it all got straightened out.  Wait until you get the actual letter in the mail for the explaination.   Perhaps its something your surgeon can go to bat for you .... a peer to peer review.  Just dont give up!  Keep fighting!!  Good luck!  Cindy

Keep trying - don't give up! Your surgery center wants the money -- make them help you!