Cigna - Insurance update

[Guest guest]

Hi -

I'm a, Mom to Gentry, who is eight months old today. Gentry was

banded (DOC) in Dallas at 6-1/2 months old due to positional plagio

(moderate). The results obtained in 1-1/2 months have been astounding. He

is 'rounding' quite nicely.

I have been lurking in the background also for quite some time now, and

am so grateful for the wealth of information and education I have received

through this group. Of course I must share with you the information I have

just received from Cigna (I can't type fast enough!).

After one appeal letter, Cigna has decided to pay for Gentry's band

" out-of-network " - meaning they will pay 80% of the $3,000 charge. (Someone

pinch me.... this seems too good to be true.) I just happened to call

Cigna last week to check on the status of the claim; but my real intent was

to see why I had not heard from them regarding my appeal. The man on the

telephone looked through the file, but did not mention the appeal status.

He informed that he could not see where this claim had been paid, and that

he would resubmit the claim. He said he'd call me back with information.

Never heard back, and that was last Friday. Today, I called again. The

claim was processed on 5/13 - 80% paid. Unbelievable. I even already had

my next letter ready to appeal again, full of ammo that I had received from

this group.

Of course, I'd rather have 100% reimbursement, but feel satisfied with

this percentage. (But then, next week I might just still be mad enough and

pursue that 20%.) And I must share a secret. When I mailed my appeal

letter to Cigna, I sent it in an envelope from the lawfirm I work for (not

their letterhead, just the envelope). Maybe that made a difference.

And a note to the Mom (if you're out there) who was in the card shop on

Lover's Lane. My heart just soared when I saw your baby in his/her DOC

Band. I couldn't get to you before you drove off. " Just wanted to let you

know my baby wears one too! " Yours is the only other baby I've seen wearing

one. I felt so happy for you!

Thanks everyone.

a - Mom to Gentry (banded 4/6/01)