Question:
update on insurance approval

Hey everyone, I had my 2nd visit with my surgeon on 3/27 , my hubby went with me to ask questions etc. Anyway, everything is a go except for the insurance approval. I am pretty sure that CIGNA PPO will pay for the surgery if they will every get off their collective duffs and get my paperwork to the proper medical review people. That is why I am writing to tell you of the merry go round I have been on. I orignally saw the Doc on 2/21 and his office sent out my letter of medical necessity that same day. A few days before I went to the 2nd visit, I called his office to find out if they had heard from the ins company. They had. Cigna had asked for "more information" and the doc's office sent it. After my appt I called cigna and asked what the status of my paperwork was, and they said the NEVER GOT IT!!. So I got the office to fax it again. To make a long story short I called cigna for 5 days in a row and they still hadn't recieved my information (lie). So on Friday, I called again, and talked to the my contact person who said she still hadn't rec'd my info. I then called the doc's office again and the ins clerk there assured me that she had sent it all 5 times and had the fax confirmation sheets to prove it. So I then called back and asked for a supervisor, but they ALL were in a meeting (yeah,right) so I got another sort of manager on the phone and she tried to be condescending to me, but I didnt back down. She tried to say that maybe the doc's office had the wrong fax number.... yep, its not cigna's fault. So I proceded to get very ugly (they don't know who they are messing with) and demanded that I have an answer that day about whether or not they found my paper work and that I wanted them to call me back at work. After I hung up I was steaming. In about 5 mins, guess who called me back? The Cigna people. Guess what they found? My paperwork. What do ya know!! It had *JUST* been put in the contact person's box....uhh huh.... Anyway, I was just wondering how many people have had this happen, and what would be the best way to get them to expidite my medical review? They recieved the original paperwork over 40 days ago (the paperwork they said they didn't get). Should I continue to call them everyday? I want them to know that I have not gone away, and that I will be a pain in their collective rear ends until they tell me one way or another. Please tell me of your experiences and how yall handled a similiar situation. I sure hope to be joining the ranks of those of you with surgery dates soon. Take care    — Valerie B. (posted on April 1, 2000)

April 1, 2000
Valerie, that is what the people are hoping for. You to go away. I encourage you to stay on them. Call everyday or every other day. My insurance did me the same way. It took those slow pokes 12 weeks to approve me. Bur, hey, I got it finally. Keep calling them, and do not give in to them. Remeber, why you want this surgery. I wish you luck.
   — Lee Ann B.

April 2, 2000
I agree with Lee Ann; they want you to go away. Why wouldn't they? They will save money in the short term if you do, and if they are lucky, you will change carriers before you have any serious complications of obesity. I was denied, and won on appeal. Call them, and write constantly (snail mail). Be polite and respectful, but let them know in no uncertain terms that you will NEVER go away. I wrote to all my legislators. Didn't get much of a response, but I made a list of them all and sent that to the insurance company. Just knowing that I was making such waves got some action from them. I filed a complaint with the state insurance board, and copied every letter I wrote to the ins company to my doctor, my surgeon, the insurance board, and my legislators. My file ended up being over 200 pages in length. I basically threw a polite and respectful hissy fit. I did this because everyone here on this board and elsewhere said that's what you should do. Listen to them; it works.
   — Linda K.

April 3, 2000
ABSOLUTELY!!!!! Call them everyday. Call them twice a day. Sooner than later they will want to get rid of you. My husband called our insurance once in the morning and once in the evening. He made a total menace of himself and I was approved right away. NEVER GIVE UP!!!! FIGHT -- FIGHT -- FIGHT
   — Jen L.