Insurance hope- 9 months post op

[Jgoody]

Hey y'all,

So I'm about 9 months post operation. My insurance (cigna) denied the claim a few weeks before surgery after initially approving it to me on the phone verbally, so I had to scramble to come up with the funds & even maxed out a credit card plus got another one & threw it all at it. It was stressful to do but we were just barely able to come up with the 18k out of pocket to get it done. The insurance quote amount was around 80k which is quite a difference.
Anyway, we appealed the decision shortly after surgery & have been sort getting the run around over having the "right codes" and dealing with their foreign outsourced call center each time we call & having to refile it even due to silly reasons, etc.

But after months of this run around we were told today that they have accepted the claim & are sending a check to the hospital- I believe in the amount insurance quoted amount in the 80k range, which is nuts & then apparently the hospital will pay us back, maybe minus unmet deductible. So I'm not sure how it will pan out exactly at this point but I hope this can offer hope to others that an appeal can work & I honestly had next to no hope in cigna accepting this claim & was even told by them at one point later in the process that implants aren't covered. So based off my experience I'd encourage others in similar situations to file an appeal & check in regularly & be a squeaky wheel as it appears to have worked for me. As of right now they have accepted the appeal & claim to be sending a check to the hospital.

I'll update the outcome if others are interested but side note- loving the implant 9 months in & sensation is back as good as it's ever been. My orgasms now are also stronger than ever so it's been a good experience for me.

[LastHope]

This is a great victory! Be a squeaky wheel - Great tip.