CIGNA update - PAID!

September 9, 2003

Hi all

Just thought I'd post an update for the benefit of anyone else who is fighting

CIGNA - latest word we've heard from them is that they will cover the full cost

of the helmet. Let me recap my experience:

-In January they gave Hangar a pre-authorization for the helmet before we casted

-In July they sent us a request for a letter of medical necessity

-In August they finally denied the claim with the reason of " not medically

necessary " (don't you love that?).

My husband talked to his HR Rep who put him in contact with the consultant who

is his company's liason to CIGNA. This man was very sympathetic and asked us to

forward him all of the info we had (ie initial diagnosis of tort and then of

plagio, follow-ups with the cranio-facial specialist, PT visit and

instructions). He then called CIGNA on our behalf. They told him they had never

received the letter of medical necessity. He sent it on to them and lo and

behold, when he followed up with them yesterday they told him that they had just

cut Hangar a check! I looked up the claim on their website today - it was paid

and processed! (Of course I printed it out in case anything else gets " lost " )

So as of now it looks like we are in the clear, although I won't officially

breathe a sigh of relief until I get the updated claim in the mail.

I can't remember who told me to try going through the HR rep for help before

filing the official appeal - but to whoever it was - THANK YOU! It looks like it

did the trick for us, still fingers crossed that this is finally over!

Good luck to everyone else!

Janine, mom to Isabella banded 1/31/03 to sometime in April

PS. As a side note I am now fighting them to get them to pay the claim for my

annual melanoma screening - I am high risk for melanoma and have to go every

year to get checked, I've already had a couple of questionnable moles removed. I

guess that's not " medically necessary " either. Ugh!

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