2nd level appeals - any advice

December 17, 2002

Hello everyone-

I really need some advice. I have been fighting with CIGNA to get a myo. I

am in the process of what they call 2nd level appeals where my case is

reviewed by three doctors (that CIGNA chooses) who supposedly know nothing

about my case beforehand. This is a five way conference call (between the

docs, myself & CIGNA) in which I will be given the opportunity to have 15

minutes to plead my case and answer questions.

Can anyone offer any advice on how to handle this? Any questions I should be

asking them? Should I try to record the call? Do I keep my emotions in check

and remain calm and just state the facts or do I let them know how I feel?

However, my feelings are not very nice at this point - I'm well beyond the

crying phase and have even surpassed anger - I'm at all out rage right now.

CIGNA contacted me this morning to let me know that they need all my medical

records by this Friday. I always thought that the insurance company contacts

the doctors to get records but now it's my responsibility. I've had to jump

through some hoops to get this information because most of my doctors

offices say it takes 10-14 days for records release - I'm sure CIGNA knows

this. CIGNA also told me that it would look bad on my part if I failed to

get them all the records.

The doctors who will be reviewing the case are a GYN, and Family Practice

doctor and an Internal Medicine doctor.

I am getting records from my family doctor, two RE's and three GYN's all

stating that I need a myo. I would hope that these five opinions have some

weight behind them.

My biggest hurdle is probably the fact that I have not tried any

conventional medicine to control the fibroids. I've done tons of holistic

therapies but I'm sure they won't consider that. They want me on

anti-inflamatories (not sure how that would benefit), pain killers and birth

control pills. I refuse to be on pain killers for any length of time as they

mess with my stomach and bcp's are not an option because I was on them for

15 years, I'm 20 lbs. overweight and am trying to get pregnant. I'm sure

they are going to say I haven't done enough to control they symptoms.

Please, any advice will be greatly appreciated. Thank you.

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