Question:
Appeal was denied...
Appeal was denied because I have not had 12 weeks supervised diet. My doc weighed me every 3 months for 2 years but that was not good enough. I joined Weight Watchers 2 weeks ago so now my question is how long after 12 weeks of WW before I try again with Cigna? How much weight should I lose, if any? Will I have to get another referral from my primary care doc? Any help would be welcome! Thank you. — Siddy I. (posted on June 7, 2002)
June 7, 2002
weight watchers isn't a medically supervised diet....start a low cal/low
fat diet with your Dr. and go weigh in with him every couples weeks and
have him document that you are on the diet and coming in to FU with him
about it....because weight watchers isn't medically supervised, you could
probably be on their program from 112 weeks and it wouldn't be what you
said Cigna is looking for
— Jeff B.
June 7, 2002
Why don't you ask Cigna to define the term "medically supervised
diet?" Then you'll know for sure what you need to do. JK, RN
— Joya K.
June 7, 2002
Weight watcher should be fine and did your doctor write a letter stating
that you have been seeing him for weight loss I have Cigna and I was
approved with bmi of 40 and pcp letter.
— paulette A.
June 7, 2002
HEY! I HAVE CIGNA AND DID NOT HAVE TO GO THROUGH ANY OF THAT. MY DR. OFFICE
SENT EVERYTHING IN FOR ME BUT I PERSONALLY SENT THEM A LETTER EXPLAINING
WHY I WANTED THIS DONE AND I ALSO THREATENED THEM. I WANTED THEM TO KNOW
AHEAD OF TIME THAT I WOULD FIGHT THEM ALL THE WAY. ALL THEY REQUIRED WAS A
LETTER OF MEDICAL NECESSITY FROM MY DOCTOR. DID YOU THREATEN THEM WITH A
LAWYER? TRY CALLING WHOEVER HANDLES YOUR INSURANCE AT WORK. MY INSURANCE IS
THROUGH MY HUSBAND AND THE GIRL IN HIS OFFICE SAID THAT SHE WOULD HELP ME
WITH WHATEVER I NEEDED. DON'T GIVE UP. RESEARCH RESEARCH RESEARCH!!! TALK
TO YOUR DR. OFFICE AND SEE IF THEY CAN SEND AS MUCH AMMO AS YOU MAY NEED!!!
GOOD LUCK TO YOU AND I HOPE YOUR JOURNEY TURNS OUT WELL FOR YOU!
— nikki R.
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