Re: DOC band and Cigna HMO

[Guest guest]

Hi there,

I was just skimming the messages tonight and yours really caught my eye - DOCband, Dallas and Cigna. That is us!!! Let me tell you that you are very lucky that Cigna has paid $1000. We have been appealing for 12 1/2 months and haven't gotten a penny from them for 2 DOC bands. When we started, Starbands were not yet available in Dallas, so DOC bands were the only option. I'm sure that's why they are now saying that $1200 is the allowable amount, but ask Dustie about her Dallas Starband experience. DOC bands are still the only viable option in Dallas, but Cigna won't admit that. I have been through 2 appeals with Cigna, an external review, and I am currently awaiting the results of an appeal through my husbands employee benefits committee. They've been working on it since November and I'm way out of patience for them, but I'm at their mercy. All I can say is keep appealing. I submitted a long list of names of people that Cigna has paid for DOC bands for, and most of them were here in the metroplex, but it didn't help our appeal. They are very inconsistent. There was a legal case against Cigna for DOC band coverage and it was a landslide in favor of the plaintiff, but even that has not helped in regards to them paying for these bands. Keep on them and see if you can't get more money out of them. But like you said, bands are worth every penny you pay for them. Let me know if I can help you with anything. By any chance is your insurance through Nortel?

Gail, Sam and Sara's mom, DOC grads

does anyone else have a DOC band and Cigna HMO

I am new to this group so I'm not sure if the info is out there somewhere already and I just didn't find it. My son, , has been wearing a DOC band since the beginning of February. We go to Cranial Technologies in Dallas. I had to go through 2 appeal processes with Cigna HMO in order for them to approve the band. They finally approved it but I just got the EOB and they are only paying $1000 of the $3000 that the band costs. They say that pay 100% of the $1200 covered amount after the $200 deductible which leaves our out of pocket costs at $200 plus the $1800 that is not covered. For all the office visits that we go to and the custom molding, etc. I can't believe that they think $1200 is adequate to cover the costs. *** Has anyone gotten the insurance companies, particularly Cigna HMO, to pay more for the cost of the DOC Band? ***BTW, is doing very well with his band and it is completely worth the money but I would obviously prefer that the insurance company paid more. Isn't that why we have insurance?For more plagio info