Cigna: round 3 (or is it 4?)

[Guest guest]

Ah, there's nothing like returning home from a nice family vacation only to find another DENIAL letter from CIGNA. AAAARRRGH!!! I am totally dumbfounded and disheartened! First I need to vent, then I have some questions for ya'll...

"The Appeals Committee contained a physician who specialized in Internal Medicine." Uh, what does this have to do with my case and why would I want an internist making decisions about my baby's heads?!

They are still rejecting the efficacy of DOC bands by vaguely referencing journals. Here's what they referenced: "controlled studies published in refereed medical journals" and "national reviews by several sources". Why is it that I had to submit carefully documented references with my appeals, yet they can get away with this?!?!?!?!?!?

I'm fuming...

Now for my questions about external reviews...

1. Does anyone know anything about Plus in Philadelphia or Medical Care Management Corp. in Bethesda, land? These are the 2 independent reviewers that we have to choose from.

2. How long does an external review take?

3. How do independent review organizations make their money? I'm curious about this since Cigna is the one providing us the information about them.

My husband is calling the attorney in the morning because he is sick of dealing with Cigna, so I want to hear from any of you who have gone through an external review to find out if it is quick enough for us to take the time to do it or if you would recommend handing it over to a lawyer at this point. (sorry about the run-on sentence). I'll definitely be calling "on behalf of the appeal committee", but I know she won't do anything for me. It'll just make me feel better.

Ok everyone, here's where I need all your kind words of support and encouragement. I'm sure I would have given up a long time ago if it weren't for the help you've given me, so please don't stop now. Am I pitiful or what!?

Gail, Sam and Sara's mom, enraged Cigna crusader