Question:
Has Any gone thru 2nd Appeal with CIGNA HEALTHCARE?

I have been denied twice by cigna due to not meeting their criteria. I am now at the 2nd Appeal level, where I have the opportunity to go before a commitee and state my case. Has anyone out there experienced this process???    — vmckel3783 (posted on June 13, 2001)

May 8, 2003
Hey Veronica.. I just went through the crap w/ Cigna..I say crap because they have denied me by the same paragraph that they have copied from each denial. The denied because I must show 2 attempts at weight loss...I gave a letter from Dallas Hypnosis stating that I had attended 18 weeks of private sessions and 1 1/2 years of weekly support. (I lost 65 lbs, but only because I was throwing-up..really wanted the hyp. to work) Along with 18 consecutive weeks of weight watchers...thinking that it would be 6 months by the time all said and done. The third reason of denial was the need for pre-surgery psychological, multi-personality test...I submitted the letter from the psy. stating that I took the test,and he recommended me for the surgery. The second denial had some pediatric medical director (who obviously had no clue) who said that I obviousdly could loose on other methods....sure, I can stay motivated and on a diet loosing 3 lbs / month..if I continued on weight watchers. My surgen said that I can now get a third appeal. I know, that since they keep repeating that my policy( That I pay 469/mo. for two) specifically states that they will not cover the treatment of obisity, except where deemed medically necessary. I had a letter from my PCP stating the medical nec., 2 bar. surgeons, an ENT (sleep apnea), both weight loss attempts, and psych. eval....NO LUCK. If I have the chance for a third, I will stick only to the facts and answer each of the three stated denial reasons, and no more. I really think that the denial is based solely on the wording of my policy. Good luck, I will be here if I can help. Mary
   — marymosman