Question:
Can anyone give me any tips about a Peer to Peer Review?

   — Anniee M. (posted on September 4, 2003)

September 5, 2003
Can you give us a little more information? A review for what?
   — Wendy D P.

September 5, 2003
I was denied by the notorius CIGNA HMO due to the last of 2 26 weeks diet programs. I do have this information some of the documentation I just recieved from Jenny Craig last week. So when CIGNA initially reviewed my info that didn't have it. Because my surgery is at the end of this month I decided to take the documentation to my Doctor's office and have him do a peer-to-peer review to overturn my denial. This usually takes a couple of days for the to say yes or no.
   — Anniee M.

September 5, 2003
I do the approvals for my doctor. I know that I have had a few patients that Cigna said "did not meet requirements". I have been able to have my doctor do a peer to peer review with the insurance company. The surgeon will talk to a medical director and besically tell them why this patient needs surgery. They sorta talk the ins comp into approving the patient. The few I am thinking about were all approved after the peer to peer review. Good Luck
   — Mandybub