Re: Alan's update:: :=(-not encouraged

[Guest guest]

RCJ...

Why am I not encouraged that your outcome will be any better than

mine? But thanks for the warning.

I'll let you know how this plays out.

Alan

> Hey Alan,

>

> It is possible that my Cigna story tops yours. I just received a

letter TODAY stating that Cigna finally has all of the information I

have sent in (all 37 pages) and it has been forwarded to Claim

Processing.. furthermore I should allow 30-45 days for the claim to

be processed. Fine and dandy considering that my surgery was nearly

TWO- yes that's right- TWO years ago!!!

>

> Glad I didn't need to be a slave to my insurance.....I'll keep you

posted as to the final outcome---'course it sounds like you will have

your info before me!

>

> Regards,

>

> Rock climbin' Jude

> LBHR De Smet 09/11/02

>

> Alan's update:: :=(

>

> , Dave, Steve...and gang...

>

> Gather 'round, Hippy Kids and I'll tell you a story. You know it

> won't be real happy, since it involves an insurance (say, what???)

> company.

>

> Called CIGNA's predetermination office today (Nikki at JRI said

I'd

> likely get more out them than she would, unless a request for

> coverage had already been approved or denied. She hadn't heard

> anything, and I know I haven't.) After futzing with the phone

tree

> for a few minutes, I got a sweet young thing (heretofore to be

known

> as SYT) who didn't know anything about my case. I spelled it, she

> went to look...came back and said " this is the Medical

> device? " I said...yes. She said the request had been submitted

for

> review on June 8th.

>

> Now the observant hippy will note I had seen Dr. Amstutz on May

5th.

> The young CIGNA thing confirms that, indeed they did get the

papers

> from JRI on MAY 10th. And then she says " we submitted the case

for

> review JUNE 8th. "

>

> To which I said... " what happened in the month between May 10 June

8? "

>

> She said: " Nothing happened, until we filed the request for review. "

>

> " A month after it arrived? " I asked...believing, but not wanting

to.

>

> " Well, yes, " she said.

>

> Me: " So what happens now? "

>

> SYT: " We should have an answer within 30 business days " .

>

> ME: " Whoa, now. I called two weeks ago tomorrow, and you told me

> we've and answer in three to five working days...HOW DOES THAT

> HAPPEN? "

>

> SYT: " I don't know for sure "

>

> ME: " You're telling me CIGNA left my case sitting on a desk

untouched

> for a month, now I get to wait 30 more business days? "

>

> SYT: " Well, that's how long the review takes " .

>

> ME: " You told me three to five days...two weeks ago. Do you have

any

> way to speed this process? "

>

> SYT: " We could make as a priority case. "

>

> ME: " Does that mean the process would start over? "

>

> SYT: " Yes. "

>

> ME: " If we start over, and you mark the file " priority " ... how

long

> before we have an answer? "

>

> SYT: " Ten business day. "

>

> ME: " What would it take to mark it " priority " ?

>

> SYT: " I could do that right now. "

>

> ME: " Well, would you please do it now? "

>

> SYT: " Yes, sir. "

>

> There were a few more niceties, but you get the picture. I

wouldn't

> be the least surprised if CIGNA denied the coverage just because I

> made some noise, but the alternative was really no better.

>

> A long story with no punchline... I'm off to a photo shop to see

if

> I can get my x-rays digitized for the e-trip to Belgium. I don't

> have a very good feeling about what will happen in a

CIGNA " priority "

> review...or how long the papers will sit somewhere before a review

> committee actually does see them; or for that matter whether the

> review amounts to a guy named Norm standing at the stairs and

tossing

> case files... the lower the file lands on the steps, the longer

you

> wait, and the more likely you are to be denied. My file may have

> landed in the basement.

>

> Hobble on, Hippies..

> Alan

>

>

>