Cigna PPO is reviewing predetermination, again

[Guest guest]

Here we go again. I received the denial letter last Friday..called

them up today regarding what other info they would need for an

appeal. They basically sent a form letter which stated that not

enough info was given to establish medical necessity and they listed

examples ie photos, letter from dr, etc. CT had sent them a packet

containing measurements from an anthropologist stating the severity

of ons plagio, along with a 2 page letter from the pediatrician

(which by the way is also 's son Trentyn's ped, too) of

medical necessity...given all that we had high hopes...even CT was

surprised with the denial. Anyhow...I called Cigna today and the rep

told me that they are reviewing the predetermination because they

just received the letter from my ped...which is a load of c**p...can

you believe that...and then to top that off...she told me to call

back in three weeks to find out the status...guess what...I'm calling

back in two days...hehe...but I'll be nice . Just had to vent.

Thanks for listening.

Lori and on doc fitting 6/23/03

[Guest guest]

Dang Lori - that REALLY stinks. I cannot believe that with all the things you

provided that they would send you a letter saying they don't have enough info.

You bet you should call back in two days. Three weeks??? Are they

insane??? Don't answer that - we all know they are!! Stick with it - I think you

will win this one yet. Keep after them though - the squeaky wheel gets the

grease!!

Marci (Mom to )

Oklahoma

-- In Plagiocephaly , " lorikhall " <lorikhall@y...> wrote:

> Here we go again. I received the denial letter last Friday..called

> them up today regarding what other info they would need for an

> appeal. They basically sent a form letter which stated that not

> enough info was given to establish medical necessity and they listed

> examples ie photos, letter from dr, etc. CT had sent them a packet

> containing measurements from an anthropologist stating the severity

> of ons plagio, along with a 2 page letter from the pediatrician

> (which by the way is also 's son Trentyn's ped, too) of

> medical necessity...given all that we had high hopes...even CT was

> surprised with the denial. Anyhow...I called Cigna today and the rep

> told me that they are reviewing the predetermination because they

> just received the letter from my ped...which is a load of c**p...can

> you believe that...and then to top that off...she told me to call

> back in three weeks to find out the status...guess what...I'm calling

> back in two days...hehe...but I'll be nice . Just had to vent.

> Thanks for listening.

> Lori and on doc fitting 6/23/03

[Guest guest]

Boy, I must have missed quite a bit while on vacation. Lori, are you

here in Dallas as well? Ok, stupid question. You said that

Trentyn's ped was on's ped. Hey, I don't know if anyone has

pointed you in the direction of Gail, she is in Dallas as well. She

has been appealing Cigna for like 15 months. You might want to email

her to see if she has anything you don't. Just a thought.

Dustie

--- In Plagiocephaly , " lorikhall " <lorikhall@y...>

wrote:

> Here we go again. I received the denial letter last Friday..called

> them up today regarding what other info they would need for an

> appeal. They basically sent a form letter which stated that not

> enough info was given to establish medical necessity and they

listed

> examples ie photos, letter from dr, etc. CT had sent them a packet

> containing measurements from an anthropologist stating the severity

> of ons plagio, along with a 2 page letter from the

pediatrician

> (which by the way is also 's son Trentyn's ped, too) of

> medical necessity...given all that we had high hopes...even CT was

> surprised with the denial. Anyhow...I called Cigna today and the

rep

> told me that they are reviewing the predetermination because they

> just received the letter from my ped...which is a load of

c**p...can

> you believe that...and then to top that off...she told me to call

> back in three weeks to find out the status...guess what...I'm

calling

> back in two days...hehe...but I'll be nice . Just had to vent.

> Thanks for listening.

> Lori and on doc fitting 6/23/03

[Guest guest]

Lori,

I can understand your frustration...We use the Dallas CT also..I was

there having to send additional documentations..When I talked to CT,

they do not originally send the pictures...They send what the band

is..I had to send my insurance the Doctor's notes and CT did that

also...Believe it or not, it takes insurance one week to get the

documents into the computers..They told me the same thing..call back

in a week...Keep calling and calling...Good luck.

Randi

mom to Drew almost 7 months DOC band 4-28

--- In Plagiocephaly , " Marci Corey " <marcisch@a...>

wrote:

> Dang Lori - that REALLY stinks. I cannot believe that with all the

things you

> provided that they would send you a letter saying they don't have

enough info.

> You bet you should call back in two days. Three weeks??? Are they

> insane??? Don't answer that - we all know they are!! Stick with it -

I think you

> will win this one yet. Keep after them though - the squeaky wheel

gets the

> grease!!

>

> Marci (Mom to )

> Oklahoma

>

> -- In Plagiocephaly , " lorikhall " <lorikhall@y...>

wrote:

> > Here we go again. I received the denial letter last

Friday..called

> > them up today regarding what other info they would need for an

> > appeal. They basically sent a form letter which stated that not

> > enough info was given to establish medical necessity and they

listed

> > examples ie photos, letter from dr, etc. CT had sent them a

packet

> > containing measurements from an anthropologist stating the

severity

> > of ons plagio, along with a 2 page letter from the

pediatrician

> > (which by the way is also 's son Trentyn's ped, too) of

> > medical necessity...given all that we had high hopes...even CT

was

> > surprised with the denial. Anyhow...I called Cigna today and the

rep

> > told me that they are reviewing the predetermination because they

> > just received the letter from my ped...which is a load of

c**p...can

> > you believe that...and then to top that off...she told me to call

> > back in three weeks to find out the status...guess what...I'm

calling

> > back in two days...hehe...but I'll be nice . Just had to

vent.

> > Thanks for listening.

> > Lori and on doc fitting 6/23/03