Re: Cigna - - Gail

[Guest guest]

Yep....I won I got Cigna to pay 100% and I put the checks in the bank

last night...

Gail do not feel bad you have to take control and let them know they

will NOT push you around...stay strong.

> > > Marci,

> > > Thanks for replying. I knew you won on external review, so I

> was

> > waiting to

> > > hear from you. We don't have to pay anything for the review,

> but

> > I do have

> > > to hassle with it and write one more letter. I got a bit of

> good

> > news

> > > tonight. Do you remember - Owen's mom? She beat Cigna a

> > few months

> > > ago and was the reason I found and joined this group. I

emailed

> > her earlier

> > > and she replied with some great information, including the fact

> > that they

> > > used MCMC for their external review, and that is one of our

> > choices. There

> > > it is - they overturned at least one denial for DOC band

> payment.

> > That's

> > > what I was looking for, and in the next few days I will be

> > submitting the

> > > paperwork and request to have them review our case.

> > >

> > > I also want to share that I was inspired by Trisha and was able

> > to " exchange

> > > words " with someone at Cigna today. I even raised my voice a

> > little. I

> > > asked her a question about getting a name and number of a

> specific

> > contact

> > > and she replied by telling me to just call member services at

> the

> > 1-800

> > > number. That was the staw that broke this camels back and I

> told

> > her that

> > > that is unacceptable and I have documented every time that I

> have

> > called

> > > them and the left hand doesn't know what the right hand is

doing

> > and she

> > > better get me a name soon! I've been calling member services

> > about this

> > > since February and have yet to get even one question answered.

> I

> > told her I

> > > needed information immediately as we are putting together our

> > legal case

> > > against Cigna (which is true because my husband contacted Bill

> > Fynes today).

> > > Now, tonight I'm feeling bad for being snippy with her, but

they

> > have NEVER

> > > been nice to me, and turnabout's fair play!

> > >

> > > (By the way, Trisha, I used your name today. I asked the lady

> at

> > Cigna why

> > > they paid for Braeden's band just last week when they told me

> they

> > won't pay

> > > for procedures that are experimental and unproven. There was

> > silence on the

> > > other end of the phone.) They're wrong and they know it.

> > >

> > > More updates later...

> > >

> > > Gail, Sam and Sara's mom, DOC grads

> > >

> > > Re: Cigna: round 3 (or is it 4?)

> > >

> > >

> > > > Gail,

> > > >

> > > > I know I am a bit late in responding, but I wanted to share

my

> > experience.

> > > I

> > > > went through EXACTLY what you are going through. We didn't

get

> a

> > choice

> > > about

> > > > which review board to use. It was a randomly selected board

as

> > far as I

> > > > understood. I had to pay $50, but with the understanding that

> I

> > would get

> > > > that money back if I won the review. I can't remember how

long

> > it took,

> > > but

> > > > it was probably about 1 1/2 months. It was worth it though

and

> > if I had

> > > not

> > > > won I would have pursued it in small claims court.

> > > >

> > > > I'm sorry that Cigna is stupid. I think you will win the

> > external review.

> > > My

> > > > external review board cited a national document of some sort

> and

> > that

> > > coupled

> > > > with the letter of medical necessity from my specialist was

> what

> > > overturned

> > > > the decision.

> > > >

> > > > Good luck with whatever you decide to do. I know how pissed

> and

> > frustrated

> > > > you must be right now - I can remember how I felt and it

> sucked!!

> > > >

> > > > Marci (mom to )

> > > > Oklahoma

> > > >

> > > >

> > > > For more plagio info