Guest guest Posted September 9, 2003 Report Share Posted 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! This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. This communication may contain information that is protected from disclosure by applicable law. If you are not the intended recipient, or the employee or agent responsible for delivering this communication to the intended recipient, be advised that you have received this e-mail in error and any use, dissemination, forwarding, printing or copying of this e-mail is strictly prohibited. If you believe that you have received this e-mail in error, please immediately notify Edgewater Technology by telephone at (781) 246-3343 and delete the communication from all e-mail files. Quote Link to comment Share on other sites More sharing options...
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