Cigna denied surgery for Clavell

The final frontier. Deciding when, if and how.
Pamen116
Posts: 280
Joined: Tue Dec 03, 2019 7:33 pm

Cigna denied surgery for Clavell

Postby Pamen116 » Wed May 01, 2024 11:41 am

Not sure what to do- my implants been broken for a few years and now I finally get insurance to help me and they deny me….


Anyone have a any advice on what I can do?
30 yrs old. Current IPP failed in 2022. Waiting revision. No insurance. I’ve had both Titan & AMS.

Floridaspeedo
Posts: 305
Joined: Fri Jun 17, 2022 11:15 am

Re: Cigna denied surgery for Clavell

Postby Floridaspeedo » Wed May 01, 2024 12:01 pm

I have Cigna and there are many plans and they approved it.

Clavell's office should be working on it.

My initial request was denied but then they found it approved under "gender re-assignment." No I did not go w the gender reassignment but it gave Cigna what it needed to approve my implant.


Joe
ED survivor 5 years. Tried pills, Gainswave, PRP, Bi-Mix/Tri Mix (worked 50% but very painful for 24 hours after injection.) 55 Gay - Single Titan Coloplast implanted June 1st, 2022, scrotal in Miami by Dr Billy Cordone..,very happy. Zero regrets

Pamen116
Posts: 280
Joined: Tue Dec 03, 2019 7:33 pm

Re: Cigna denied surgery for Clavell

Postby Pamen116 » Wed May 01, 2024 12:57 pm

Floridaspeedo wrote:I have Cigna and there are many plans and they approved it.

Clavell's office should be working on it.

My initial request was denied but then they found it approved under "gender re-assignment." No I did not go w the gender reassignment but it gave Cigna what it needed to approve my implant.


Joe



Dr Clavells office advised they would not put “gender reassignment” on legal documents.
30 yrs old. Current IPP failed in 2022. Waiting revision. No insurance. I’ve had both Titan & AMS.

Journeyman
Posts: 603
Joined: Fri May 12, 2023 3:46 pm

Re: Cigna denied surgery for Clavell

Postby Journeyman » Wed May 01, 2024 1:24 pm

Pamen116 wrote:Not sure what to do- my implants been broken for a few years and now I finally get insurance to help me and they deny me….


Anyone have a any advice on what I can do?

The short version of my story is Dr. Clavell did a " peer to peer " review with the insurance companies Dr representative and it got approved. Yeah it was stressful but he got it done
54 - Coloplast Titan 22cm , Implanted by Dr. Clavell in April 2023

Pamen116
Posts: 280
Joined: Tue Dec 03, 2019 7:33 pm

Re: Cigna denied surgery for Clavell

Postby Pamen116 » Wed May 01, 2024 1:38 pm

Journeyman wrote:
Pamen116 wrote:Not sure what to do- my implants been broken for a few years and now I finally get insurance to help me and they deny me….


Anyone have a any advice on what I can do?

The short version of my story is Dr. Clavell did a " peer to peer " review with the insurance companies Dr representative and it got approved. Yeah it was stressful but he got it done




What insurance do you have? My insurance is denying a peer to peer with Clavell because they’re saying it’s excluded
30 yrs old. Current IPP failed in 2022. Waiting revision. No insurance. I’ve had both Titan & AMS.

Journeyman
Posts: 603
Joined: Fri May 12, 2023 3:46 pm

Re: Cigna denied surgery for Clavell

Postby Journeyman » Wed May 01, 2024 2:11 pm

Pamen116 wrote:
Journeyman wrote:
Pamen116 wrote:Not sure what to do- my implants been broken for a few years and now I finally get insurance to help me and they deny me….


Anyone have a any advice on what I can do?

The short version of my story is Dr. Clavell did a " peer to peer " review with the insurance companies Dr representative and it got approved. Yeah it was stressful but he got it done


Anthem/ Blue cross

What insurance do you have? My insurance is denying a peer to peer with Clavell because they’re saying it’s excluded
54 - Coloplast Titan 22cm , Implanted by Dr. Clavell in April 2023

Journeyman
Posts: 603
Joined: Fri May 12, 2023 3:46 pm

Re: Cigna denied surgery for Clavell

Postby Journeyman » Wed May 01, 2024 2:12 pm

Pamen116 wrote:
Journeyman wrote:
Pamen116 wrote:Not sure what to do- my implants been broken for a few years and now I finally get insurance to help me and they deny me….


Anyone have a any advice on what I can do?

The short version of my story is Dr. Clavell did a " peer to peer " review with the insurance companies Dr representative and it got approved. Yeah it was stressful but he got it done




What insurance do you have? My insurance is denying a peer to peer with Clavell because they’re saying it’s excluded

Anthem/ Blue cross
54 - Coloplast Titan 22cm , Implanted by Dr. Clavell in April 2023

User avatar
rdnkbiker
Posts: 319
Joined: Thu Dec 22, 2016 5:49 am

Re: Cigna denied surgery for Clavell

Postby rdnkbiker » Wed May 01, 2024 2:43 pm

Just be real sure with CIGNA..... on my first implant they said its covered conformation # whole bit 3 days before surgery they sent a letter said the will NOT cover the implant Doc and hospital said they can't do that already have everything said i should just get it done....well got stuck with a 89k bill so just be careful.... l all I'm saying
HBP since my 20s Full ED i was 55 when i received my implant January 17th 2017 sever scare tissue through corpora cavernosa clear to the glands (no blood flow) complete revision new equipment july 10th 2023 AMS CX 21cm very happy

Pamen116
Posts: 280
Joined: Tue Dec 03, 2019 7:33 pm

Re: Cigna denied surgery for Clavell

Postby Pamen116 » Wed May 01, 2024 3:29 pm

I’m stressed out. I can’t believe this company is excluding this surgery. Cigna stated they wouldn’t even do a peer to peer- I hate this. Idk who I should contact next? Maybe my HR department ?
30 yrs old. Current IPP failed in 2022. Waiting revision. No insurance. I’ve had both Titan & AMS.

Jage64
Posts: 616
Joined: Sat Oct 22, 2022 9:38 pm

Re: Cigna denied surgery for Clavell

Postby Jage64 » Wed May 01, 2024 3:50 pm

rdnkbiker wrote:Just be real sure with CIGNA..... on my first implant they said its covered conformation # whole bit 3 days before surgery they sent a letter said the will NOT cover the implant Doc and hospital said they can't do that already have everything said i should just get it done....well got stuck with a 89k bill so just be careful.... l all I'm saying


I paid out of pocket $21k for everything.

You got stuck with an $89k bill? :? I hope you have 4 dicks.
2/22/23 AMS 700 CX 21cm + 1.5cm RTEs. 58 yrs old, wife of 37 yrs. Penoscrotal. 100ml Conceal reservoir. Dr. Clavell. Pills failing and went right to implant, skipped the injections. 12 mos. later: 7 1/2" x 5 3/4"


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