Re: Hi, new here from Houston

[Guest guest]

Tina,

Welcome...I am on Cigna too...and just got declined yesterday because "the DOC band is not more effective than any other method" what ever that means....I haven't gotten my letter yet I called Cigna and they told me the reasons...I have already started to gather information for my appeal...I would call Cigna and find out why they denied it...that will give you an angle to start working from for the appeal...at least that is what I am doing ...my ds had his casting today he is 4 1/2 mos old...they say the earlier the better...so basically I went begging to my parents for the cash...CT is doing a payment plan of $600.00 down and $350.00 a month...HTH...Trisha

-----Original Message-----From: princess_26_tx [mailto:princess_26_tx@...]Sent: Wednesday, May 15, 2002 3:35 PMPlagiocephaly Subject: Hi, new here from HoustonI've been reading ya'lls posts, and I am so thankful there are people to chat with about our plagio babies.I have a 6month old ds named Logan.Last Thursday I found out that our insurance, Cigna, has denied our docband. Friday the doctor's office called to inform me that the doctor himself was going to call Cigna and explain the medical necessity.Well, I of course have called the dr's office everyday this week to find out the outcome. I finally was able to speak to the dr's secretary about 20 minutes ago, and she said that she didn't know and that she would call me back.I'm so tired of waiting, I had to wait 5 weeks after his head measurments just to find out that we were denied. I just want to know if I should start gathering info for my appeal, and go ahead and schedule a casting.Thanks so much for letting me vent!TinaFor more plagio info

[Guest guest]

Trisha,

I actually recieved my letter of denial yesterday, they said that it

was denied due to " no documentation of a funcional abnormality that

is being corrected and therefore considered cosmetic. " That is such

BS...sorry...it just makes me so mad.

> Tina,

> Welcome...I am on Cigna too...and just got declined yesterday

because " the DOC band is not more effective than any other method "

what ever that means....I haven't gotten my letter yet I called Cigna

and they told me the reasons...I have already started to gather

information for my appeal...I would call Cigna and find out why they

denied it...that will give you an angle to start working from for the

appeal...at least that is what I am doing ...my ds had his casting

today he is 4 1/2 mos old...they say the earlier the better...so

basically I went begging to my parents for the cash...CT is doing a

payment plan of $600.00 down and $350.00 a month...HTH...Trisha

>

> Hi, new here from Houston

>

>

> I've been reading ya'lls posts, and I am so thankful there are

people

> to chat with about our plagio babies.

>

> I have a 6month old ds named Logan.

>

> Last Thursday I found out that our insurance, Cigna, has denied our

> docband. Friday the doctor's office called to inform me that the

> doctor himself was going to call Cigna and explain the medical

> necessity.

>

> Well, I of course have called the dr's office everyday this week to

> find out the outcome. I finally was able to speak to the dr's

> secretary about 20 minutes ago, and she said that she didn't know

and

> that she would call me back.

>

> I'm so tired of waiting, I had to wait 5 weeks after his head

> measurments just to find out that we were denied. I just want to

know

> if I should start gathering info for my appeal, and go ahead and

> schedule a casting.

>

> Thanks so much for letting me vent!

> Tina

>

>

>

>

>

>

[Guest guest]

In a message dated 5/15/02 3:38:14 PM Central Daylight Time,

princess_26_tx@... writes:

<< I just want to know

if I should start gathering info for my appeal, and go ahead and

schedule a casting. >>

Hi Tina and welcome. If you have the official denial then you should probably

go ahead with the casting and start putting together your appeal. We have a

number of people here with Cigna who have won their appeals, so hopefully the

same will hold true for you.

I'm glad you have joined us and I look forward to learning more about you!

Marci (Mom to )

Oklahoma

[Guest guest]

Hi Tina,

I live in the Dallas area and am in the middle of the appeals process with Cigna as well. Was this the only reason they denied you? If so, then the AMA statement found in Files > Help Folder > INSURANCE HELP should be of great help to you in writing your appeal letter. It looks like Cigna quoted the first paragraph of the statement in your denial, but they didn't bother to read to the bottom of the resolution where it says that they should pay for this "reconstructive" and NOT "cosmetic" procedure. If I were you, I would schedule the casting asap and let CT file with Cigna again. Have your appeal letter written, and the day you get your explanation of benefits in the mail, send your appeal to Cigna, and be sure to get some sort of delivery confirmation from the post office. Good luck and keep me posted.

Gail, Sam and Sara's mom

it was denied due to "no documentation of a funcional abnormality that is being corrected and therefore considered cosmetic."