Question:
Cigna & Intracorp

I have Cigna POS Open Access. Completed all my tests, nutr. eval and psych eval. Have date for pre-testing (10/15) and surgery date (10/21) but was told this past Monday that Intracorp has denied my surgery. My benefits state that the surgery has to be medically necessary not for weight control but the denial says that they want documentation that I was on a professionally monitored diet in the last six months. Did anyone else have this problem? I have been waiting for this surgery since August '02 and am very depressed that my surgery may be delayed for another six months. Any help is greatly appreciated!    — Carol K. (posted on September 28, 2003)

September 28, 2003
I am so sorry to hear this happened to you. I am going through an appeal with Cigna on behalf of Intracorp for my panniculectomy. Please check out the yahoo group cigna squeky wheels, they are all going through what you are and can give you good advice and support. Good Luck!
   — Stephanie B.

September 28, 2003
My husband was denied by Cigna POS also even after they said that his surgery was medically necessary. They came back 6 months after he was into the process and said that he needed 2-26 week documented doctor monitored diets with there being no diet drug aids. Fortunately he is covered by my insurance BCBS PPO of IL and does not need those things. I have heard that Cigna is making it real hard for a patient to get the surgery covered because it is so expensive. Many ppl will not go through the monitored diets and give up so guess who wins? The insurance company. Good Luck.
   — ChristineB

September 28, 2003
I have Blue cross/ Blue Shield, but it also had to go through Cigna. I was denied at first by Intracorp because OF the same reason. I had been to the doctor a few months before and of course I was told that I needed to lose weight. I was told to be on a lowfat diet (this was considered a medically supervised diet). I had high blood pressure and had to go back every few weeks to have it checked. I was weighed each time too. This counted as a medically supervised diet with monthly weigh ins. I just made sure I went in to be weighed and have that documented for the next few months. When it equaled 6 months, we sent it in again and I was approved. My surgery was 5 weeks ago and I have lost 38 pounds. I feel great. Good luck. Be persistant and you will be approved.
   — sandyh

September 28, 2003
I have GHI/Empire Blue Cross Blue Shield. I was approved by GHI but denied by Empire BC BS (My hospital insurance) they use Intracorp. I was denied for the same reason that you were b/c of the diet history. I had to hire Walter and Kelley Lindstrom to fight my appeal. They wrote one letter of representation and my denial was overturned in 3 days. I had surgery on August 7th and I have lost 40 pounds. Good luck.
   — Lisa N.