Cigna - Gail - Persons Names

[Guest guest]

Gail,

I can give you the names and numbers of the two ladies that got me

answers if you would like all I ask is dont use Braedens name until

the checks have cleared the bank I deposited them yesterday and I

dont wnat them coming back and saying " Oh that was a mistake " and

putting stop payments on them. I can send you the names of them if

you would like one is a mother and said she would be doing the same

thing if it was her child. I can also send you all of my appeals

stuff that has a bunch of references in it...LMK....my family is in

town so I havent been able to get on much but I will check back

later on and see if you need it or call me at the office I will be

there today & Thursday 972-620-9438...Trisha

> 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