Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 Hi everyone, I just wanted to ask anyone here with Cigna Healthcare insurance if you were turned down the first time you requested the surgery and if, on appeal, you were approved? After five weeks and asking for just about every document and x-ray my doctor has, they decided to deny my surgery. My oral surgeon says they do that a lot now - turn everyone down the first time, so they can save money on anyone who doesn't appeal. Have any of you had experience with this? We're working on the appeal now, but it's just disheartening. Thanks, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 I have Cigna and they are a pain in the butt. I was denied the first time and approved the second. Just be strong and put up a good fight. The key to getting my surgery approved was getting all of my doctors who knew about the pain the TMJ was causing to write letters to the insurance company explaing why i needed the surgery. Good luck. > Hi everyone, > > I just wanted to ask anyone here with Cigna Healthcare insurance if > you were turned down the first time you requested the surgery and if, > on appeal, you were approved? > > After five weeks and asking for just about every document and x- ray > my doctor has, they decided to deny my surgery. My oral surgeon says > they do that a lot now - turn everyone down the first time, so they > can save money on anyone who doesn't appeal. > > Have any of you had experience with this? We're working on the > appeal now, but it's just disheartening. > > Thanks, > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 Do read your benefits booklet carefully before you decide which tack to take. Some policies specifically exclude surgery to treat TMJ troubles, but will approve it for correction of a congenital deficiency or anomaly... Cammie > > Hi everyone, > > > > I just wanted to ask anyone here with Cigna Healthcare insurance > if > > you were turned down the first time you requested the surgery and > if, > > on appeal, you were approved? > > > > After five weeks and asking for just about every document and x- > ray > > my doctor has, they decided to deny my surgery. My oral surgeon > says > > they do that a lot now - turn everyone down the first time, so > they > > can save money on anyone who doesn't appeal. > > > > Have any of you had experience with this? We're working on the > > appeal now, but it's just disheartening. > > > > Thanks, > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 We're not even bringing up the TMJ. I have so many other problems caused by the size and placement of my jaw that we didn't need to. I just hope the appeal makes a difference. I've put so much time, energy and money into getting these problems resolved. Thanks, > > > Hi everyone, > > > > > > I just wanted to ask anyone here with Cigna Healthcare insurance > > if > > > you were turned down the first time you requested the surgery and > > if, > > > on appeal, you were approved? > > > > > > After five weeks and asking for just about every document and x- > > ray > > > my doctor has, they decided to deny my surgery. My oral surgeon > > says > > > they do that a lot now - turn everyone down the first time, so > > they > > > can save money on anyone who doesn't appeal. > > > > > > Have any of you had experience with this? We're working on the > > > appeal now, but it's just disheartening. > > > > > > Thanks, > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 CIGNA is evil. When I got married, my husband added me to his insurance, and I dropped mine through my employer. So luckily I didn't have CIGNA for my surgery and had no problems with insurance coverage. Now that I do have CIGNA, my husband and I are finding that we have to look closely at what they do. I started biofeedback therapy after getting authorization through them to have it covered as in-network. Lo and behold the statement comes and they're trying to pay as out-of-network even though they gave me an authorization number. Now they want proof of my prior insurance because they're trying to say that it's a prexisting condition and don't have to pay at all. That, of course, is not an issue since I never had a lapse in coverage. So, stay strong and fight for what is right. It's unfortunate CIGNA operates as they do, but you're not in this alone. > Hi everyone, > > I just wanted to ask anyone here with Cigna Healthcare insurance if > you were turned down the first time you requested the surgery and if, > on appeal, you were approved? > > After five weeks and asking for just about every document and x- ray > my doctor has, they decided to deny my surgery. My oral surgeon says > they do that a lot now - turn everyone down the first time, so they > can save money on anyone who doesn't appeal. > > Have any of you had experience with this? We're working on the > appeal now, but it's just disheartening. > > Thanks, > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 ,. Check out the other site... and Adiel are facing the SAME problem with Cigna...and they're more than one appeal in... you guys need to team up and take them on together maybe? and I had a back up idea posted there about individual ins plans just as an option....JO > > > > Hi everyone, > > > > > > > > I just wanted to ask anyone here with Cigna Healthcare > insurance > > > if > > > > you were turned down the first time you requested the surgery > and > > > if, > > > > on appeal, you were approved? > > > > > > > > After five weeks and asking for just about every document and x- > > > ray > > > > my doctor has, they decided to deny my surgery. My oral > surgeon > > > says > > > > they do that a lot now - turn everyone down the first time, so > > > they > > > > can save money on anyone who doesn't appeal. > > > > > > > > Have any of you had experience with this? We're working on the > > > > appeal now, but it's just disheartening. > > > > > > > > Thanks, > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 ,. Check out the other site... and Adiel are facing the SAME problem with Cigna...and they're more than one appeal in... you guys need to team up and take them on together maybe? and I had a back up idea posted there about individual ins plans just as an option....JO > > > > Hi everyone, > > > > > > > > I just wanted to ask anyone here with Cigna Healthcare > insurance > > > if > > > > you were turned down the first time you requested the surgery > and > > > if, > > > > on appeal, you were approved? > > > > > > > > After five weeks and asking for just about every document and x- > > > ray > > > > my doctor has, they decided to deny my surgery. My oral > surgeon > > > says > > > > they do that a lot now - turn everyone down the first time, so > > > they > > > > can save money on anyone who doesn't appeal. > > > > > > > > Have any of you had experience with this? We're working on the > > > > appeal now, but it's just disheartening. > > > > > > > > Thanks, > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2004 Report Share Posted August 5, 2004 Thanks, I read their messages and it's very discouraging. I've proven more than sufficient need for this surgery, but they are just being jerks about it. They said I met the first criterion, but not the second - clinical severity or functional impairment caused my the skeletal deformity. Like having trouble breathing, chewing and swallowing my whole life, as well as not being able to close my lips without forcing them, not to mention the headaches - are completely unrelated. Then they practically scold me for not turning in claims previously. It's just so rude, really. I'm going to keep going, but I'm wondering, from the posts here and on the other site, if I'll ever win. I hope everyone keeps posting about their experiences with them, and hopefully their victories. Thanks everyone, > > > > > Hi everyone, > > > > > > > > > > I just wanted to ask anyone here with Cigna Healthcare > > insurance > > > > if > > > > > you were turned down the first time you requested the surgery > > and > > > > if, > > > > > on appeal, you were approved? > > > > > > > > > > After five weeks and asking for just about every document and > x- > > > > ray > > > > > my doctor has, they decided to deny my surgery. My oral > > surgeon > > > > says > > > > > they do that a lot now - turn everyone down the first time, > so > > > > they > > > > > can save money on anyone who doesn't appeal. > > > > > > > > > > Have any of you had experience with this? We're working on > the > > > > > appeal now, but it's just disheartening. > > > > > > > > > > Thanks, > > > > > Quote Link to comment Share on other sites More sharing options...
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