Question:
UG! I have Cigna ins and I have been denied - need advise

I was denied on 2/25, I sent in my appeal letter on 2/28, since then I have been having lots of problems with my back, I was out of work for 6 days, had it x-rayed and was told I had an extra vertabrea and that was causing narrowing of my spine. Of course this is heritary and if I was skinny I would still have problems just not as bad. Weight loss would diffently approve it. Should I send this info the CIGNA? DO you think it will help?    — Debbie W. (posted on March 12, 2002)

March 12, 2002
I believe that you have the right to know why you were denied. Check to see if your ins has any exclusions for the surgery. You did not say if you were a ppo, hmo or pos with Cigna. My secondary ins is Cigna POS and I was approved with them before my primary BCBS of IL approved me. So I would check into the reason why they denied you and fight it. Sometimes people sit back and take the denial and ins co actually hope you will do that. And there are instances of ins. co. actually not having an exclusion. The ins. co can pinch a penney and make it squeek. Your bmi meets the standards what about other co-morbidities, like high bp, blood clots etc?
   — ChristineB

March 12, 2002
I, too, am pretty sure you insurance company has to give you a written explanation for denying you. If not, contact your state's insurance commission, insurance division or whatever it's called. You should be able to find it by going to www.state.xx.us where xx is the two-character postal abbreviation for your state. Also, if you do have the denial in writing, base your appeal on what they denied you for. Don't add a lot of other stuff. Keep it short and to the point.
   — garw

April 28, 2002
I have cigna also I have to tell you this but it is not cigna that denied you first it is your medical group that denied you. Mines hill physician medical group and they told me I didn't meet medical critera. So I have to go back to my doctor and find out what it was I didn't meet. Under no circumstance you should of recieved a personal denial letter by mail. Or get the copy of it from your doctor. My doctor didn't even bother to tell me I was denied I callled the medical group myself and found out and they told me why but said my doctor will now what critera was not meet. anyway I am resubmitting all the paperwork sent in befor plus some new paperwork. I have asthma and back problems I plan on seeing a chiropractor for letter to send to insurance company and a asthma specialist for a letter. These are letters that clearly state a diagnosis by a doctor. Let me ask you this did you just send in the letter by it self with no medical history attached to it. Also attach any dieting attempts clearly documented by a doctor. Do have any dieting logs from places likew jenny craig or weight watchers. I thought about joining weight watchers again while am waiting for the 1st appeal letter responce. That way they can clearly see i have troubles keeping off the pounds. Remeber it can be awhile and you need to least stay in one of those programs for at least 3months It will keep you busy whiel your waiting and you don't have to go every week with weight watchers you can go every 2 weeks. I hope this helps emial me if you have any more questions sheri burke [email protected]
   — sheri B.