Re: Cigna - Gail - Persons Names

[Guest guest]

Trisha-

Sounds like I missed something big while my computer was down.

Did you win your appeal?

Wow!

Dane's mom DOC Grad

Gail -

Don't feel bad at all for being snippy. I can't believe you you

waited this long. I'd have lit a firecracker under the bum of

member services a long time ago. My friend sells insurance and she

says it's the c/s rep's job just to hurry up and get you off the

phone!

> > 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

[Guest guest]

<<My friend sells insurance and she

says it's the c/s rep's job just to hurry up and get you off the

phone!>>

That's right! I used to work at a company that administered health insurance

policies and the customer service reps were supposed to try and answer questions

and get off the line in 1 minute or less. Anything more kind of counted against

their numbers. That's why these dipsh!ts don't want to take the time to talk

with you and help you. You have to insist and get " snippy " if you want them to

stay on the line long enough to help you.

Marci (Mom to )

Oklahoma

[Guest guest]

Trisha,

Thanks, but I don't think your contacts will be able to help me since we

have totally different policies and they are administered from different

locations. I have a strong feeling that the lady I talked to yesterday will

be providing me with a contact. The best thing that happened was that

(Owen's mom) replied to me and the external review board that overturned

their Cigna denial is the same review board that will be reviewing our case.

told me to use her name in my letter, so you can bet I'll be doing

that. We're not done yet!!!

Gail

[Guest guest]

Just wanted to help ya....I am once again sorry you are having such a

hard time but thank God for ....Best of luck...Trisha

> Trisha,

> Thanks, but I don't think your contacts will be able to help me

since we

> have totally different policies and they are administered from

different

> locations. I have a strong feeling that the lady I talked to

yesterday will

> be providing me with a contact. The best thing that happened was

that

> (Owen's mom) replied to me and the external review board that

overturned

> their Cigna denial is the same review board that will be reviewing

our case.

> told me to use her name in my letter, so you can bet I'll be

doing

> that. We're not done yet!!!

>

> Gail