Guest guest Report post Posted August 11, 2003 CIGNA PAID FOR MY SURGERY AND I WAS ABOUT 3 MONTHES OUT FROM HAVING THE SURGERY. I DID NOT GET APPROVED FOR IT FIRST. THEY WILL GET YOU THE RUN AROUND LIKE CRAZY. THEY JUST PAID ME LIKE THIS PAST APRIL AND HAVE ALREADY DENIED MY SISTER. THEY TOLD HER THAT I SHOULD HAVE NEVER BEEN APPROVED, SHE HAS NOW HIRED A LAWYER AND THEY ARE GOING AFTER CIGNA. I WISH YOU ALL THE BEST. KEEP FIGHTING THEM. AIMEE 8-21-02 328/185 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 20, 2003 Hi Cigna folks. Sounds like you are fighting for a cause. You go!!!!!! I am going to have to do the same thing to get my daughter any help. I thought they had an exclusion in her policy, have ordered a copy of the policy. Will know more later. Phyllis Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 22, 2003 I AM FROM NORTH CAROLINA AND YES IT IS A HMO AIMEE PUCKETT 8-21-02 328/184 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 7, 2004 Diane: I recently won against Cigna for the second time. My husband and I both had the MGB in 2003. If I can help give me a call 770-495-0995. Kathy Gentile 6.26.03 230/147 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 7, 2004 How did you win against Cigna? They have denied all my appeals. They said they won't pay for the MGB. Any tips? Gould MGB 9-15-00 MGB Revision 5-16-02 > Diane: > > I recently won against Cigna for the second time. My husband and I both had > the MGB in 2003. If I can help give me a call 770-495-0995. > > Kathy Gentile > 6.26.03 > 230/147 > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 8, 2004 I have Cigna PPO. If you call me (770-495-0995) I can FAX you copies of my letters along with a copy of the approval letters. My husband and I have both been paid by Cigna PPO. I received $14,575 and he received $14,375. Kathy G./Atlanta 6.26.03 230/147 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 8, 2004 Kathy, Did you have the HMO or PPO? I will definitely call you. Thanks Diane Re: cigna > Diane: > > I recently won against Cigna for the second time. My husband and I both had > the MGB in 2003. If I can help give me a call 770-495-0995. > > Kathy Gentile > 6.26.03 > 230/147 > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 8, 2004 REMINDER: High Point Support Meeting, Monday, August 9th at 6:30 at the Long Horn Steak House on Main St. in Highpoint. Hope see everyone there. Monroe Dr. Walsh/Dr. Dasher CLOS-High Point 704-682-0260 (cell) 336-841-0326 (office) npm@... www.clos.net Re: Re: cigna I have Cigna PPO. If you call me (770-495-0995) I can FAX you copies of my letters along with a copy of the approval letters. My husband and I have both been paid by Cigna PPO. I received $14,575 and he received $14,375. Kathy G./Atlanta 6.26.03 230/147 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 8, 2004 I HAVE CIGNA AND THEY PAID 100% OF MY MGB COST. I DID THREE LETTERS OF APPEAL AND THEN I HAD THE PHONE CONVERSATION AND AFTER THAT THEY APPROVED ME. MY SISTER HAS THE EXACT SAME INSURANCE THAT I DO AND THEY ARE REFUSING TO PAY FOR HERS. SHE MISSED HER PHONE CONVERSATION AND I THINK THAT REALLY HURT HER. GOOD LUCK AIMEE 8-21-02 328/165 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 9, 2004 Hey Aimee litter Mate Girl!!! What do you mean she missed her tel conversation???? Marleen St Louis >From: WILLEITH@... >Reply- > >Subject: Re: Re: cigna >Date: Sun, 8 Aug 2004 22:29:22 EDT > >I HAVE CIGNA AND THEY PAID 100% OF MY MGB COST. I DID THREE LETTERS OF >APPEAL AND THEN I HAD THE PHONE CONVERSATION AND AFTER THAT THEY APPROVED >ME. MY >SISTER HAS THE EXACT SAME INSURANCE THAT I DO AND THEY ARE REFUSING TO PAY >FOR HERS. SHE MISSED HER PHONE CONVERSATION AND I THINK THAT REALLY HURT >HER. > GOOD LUCK > >AIMEE >8-21-02 >328/165 > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 9, 2004 Aimiee, what is your claim number? That would help those of us still fighting Cigna. IF we get it, your sister will have a better chance, and so on. Thanks, Barb Dudley, high point, 10/15/04, 242/154 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 9, 2004 MY CLAIM NUMBER WAS 0103120399929 MY CHECK WAS ACTUALLY WROTE FOR $ 17,041.92. I WAS ACTUALLY GIVEN INTEREST FROM THEM. I HOPE THIS HELPS YA'LL AND IF SO PLEASE LET ME KNOW. AIMEE 8-21-02 328/165 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 9, 2004 HI LITTER MATE, HOW ARE YOU? I HOPE THAT YOU ARE DOING GOOD. WE ARE COMING UP ON OUR 2 YEAR ANNIVERSARY AND IT DON'T SEEM LIKE IT. WHAT I MEANT ABOUT THE PHONE CONVERSATION WAS THAT AFTER MY 2 APPEALS, MRS. SONYA COVINGTON SENT ME A LETTER AND TOLD ME THAT I HAD TO TALK TO 3 DOCTORS ON A 4 WAY PHONE CONVERSATION AND I HAD 10 MINUTES TO EXPLAIN WHY THEY SHOULD PAY FOR MY SURGERY, WELL WHEN I DID THAT I WAS APPROVED THAT DAY. MY SISTER MISSED HER CONVERSATION AND SHE WAS DENIED. PLEASE LET ME KNOW HOW YOU ARE AND HOW YOUR WEIGHT LOSE IS NOW. DIDN'T YOU HAVE THE REVISION? HOW HAS IT BEEN IF YOU DID. PLEASE LET ME KNOW.. SOO GLAD TO HEAR FROM YOU. AIMEE 8-21-02 328/165 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 9, 2004 thanks Aimee, I'll keep you posted. barb dudley Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 9, 2004 Thanks Aimee, by the way , what is your full name and address? barb dudley Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 10, 2004 Hey Dear Aimee, Pleeeeeaaaaase..........send me your phone number again. Marleen St. Louis >From: WILLEITH@... >Reply- > >Subject: Re: Re: cigna >Date: Mon, 9 Aug 2004 22:08:02 EDT > >HI LITTER MATE, > >HOW ARE YOU? I HOPE THAT YOU ARE DOING GOOD. WE ARE COMING UP ON OUR 2 >YEAR ANNIVERSARY AND IT DON'T SEEM LIKE IT. WHAT I MEANT ABOUT THE PHONE >CONVERSATION WAS THAT AFTER MY 2 APPEALS, MRS. SONYA COVINGTON SENT ME A >LETTER AND >TOLD ME THAT I HAD TO TALK TO 3 DOCTORS ON A 4 WAY PHONE CONVERSATION AND >I >HAD 10 MINUTES TO EXPLAIN WHY THEY SHOULD PAY FOR MY SURGERY, WELL WHEN I >DID >THAT I WAS APPROVED THAT DAY. MY SISTER MISSED HER CONVERSATION AND SHE >WAS >DENIED. PLEASE LET ME KNOW HOW YOU ARE AND HOW YOUR WEIGHT LOSE IS NOW. >DIDN'T YOU HAVE THE REVISION? HOW HAS IT BEEN IF YOU DID. PLEASE LET ME >KNOW.. SOO GLAD TO HEAR FROM YOU. > >AIMEE >8-21-02 >328/165 > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 10, 2004 it is 919-965-6850 aimee Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 10, 2004 aimee puckett 420 herring rd Princeton, nc 27569 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 10, 2004 Thanks Aimee!!!! barb Quote Share this post Link to post Share on other sites
Guest guest Report post Posted January 2, 2005 I was able to get them to reimburse me. I had Cigna PPO and was using an MD at the time. Once you get your claim forms only mail one piece of paper at a time. Wait for them to pay the claim before sending in another one. kkinkaty <kkinkaty@...> wrote: Has anyone on this list had any luck in getting Cigna to cover any of the costs of chelation? KK ======================================================= Quote Share this post Link to post Share on other sites
Guest guest Report post Posted January 3, 2005 They have been consistently reimbursing for 70% of the cost of TD- DMPS through RX PRIME. Standard labs are very inexpensive when done through a preferred lab such as Quest. Office visits are covered at 70%. All of this assumes you're in the PPO. > Has anyone on this list had any luck in getting Cigna to cover any of the > costs of chelation? > > KK Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 29, 2005 Amy, Are you the person who had Cigna HMO and was reimbursed for the MGB? I am trying to locate that person because I have Cigna HMO and currently working on my final appeal. Let me know if you are the person I need to speak to. Thanks Diane - In , WILLEITH@A... wrote: > > > I AM FROM NORTH CAROLINA AND YES IT IS A HMO > > AIMEE PUCKETT > 8-21-02 > 328/184 > > > Quote Share this post Link to post Share on other sites
Guest guest Report post Posted August 29, 2005 Amy, please keep me posted also. My email is barbboomer@.... I have cigna ppo and have exhausted all my appeals. I saw a lawyer last week and he was going to charge me $2500 just to write a letter (to research, etc) and then a portion of anything he got. I couldn't stand the guy. He also said, which I totally agree with- get the lawyer now, if you are on your final appeal. That would be the time, I would highly recommend it. Once you've finished all your appeals, you have very little recourse. Cigna has also paid for two other people that I know of, besides Aimee. Please keep me posted. I'm looking for another lawyer now. Problem is that it has to be someone that will argue in federal court. This guy was not hopeful at all, besides the price. If he was, I might have paid it. Good luck! barb dudley, high point, oct 15, 2003, 242/145 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted February 2, 2007 Thanks Minga and yes, of course you may use any of our correspondence. SOme colleagues have pointed out that a modifier 25 should be applied to the exam. It has been explained that the definition of the 98940 codes were initially defined as an office visit or something very similar. However, i feel i would have encountered this before and i have not. So, does the OBCE know whether or not the modifier is indeed necessary. It would be easy enough i suppose if it were, but just wouldn't make much sense (to me) ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211 Re: Cigna Joe, This is my personal opinion, not the opinion of the OBCE. here's what I'd do. Copy the CJ rule from our OARs. Put a note that professional competency requires re-exams for this profile of patient contact. You can describe the info you've mentioned in your email. 1. 6-8 months since last seeing patient 2. new injury? 3. Any other new circumstances in lifestyle? Note all relevant facts that make your case require re-exam. If this is in fact NOT a simple office visit; This is a clinically required exam. Make sure you're correct in that evaluation. Then let them know that your malpractice ins carrier also requires you to be current with all clinical justification guidelines for public protection and standards of care issues. Ask them if they are willing to put into writing that they do not condone following state and federal clinical justification guidelines so that you may submit this for discussion with the federal, state and insurance regulatory boards as well as concerned state representatives and senators involved in health regulation committees; that you must answer to. This exact subject is hotly discussed at the federation of licensing boards and is of great concern to all United States licensing boards. I would like any of you who have this similar problem to contact me. Get patient permission to send me the correspondence from the carrier. Redact the patient name. Take time to write a detailed email similar to the one Joe has posted. I need ammunition for the May 2007 annual federation of licensing board's meeting. I am your Oregon representative. Joe, if you approve, may I copy all this plus the attached email from you to take to our meeting? I can only accept these descriptive issues up to May 1, 2007 in order to include in the annual meeting. Thanks. Minga Guerrero DC president, OBCE ps. please don't just send me empty complaints. Put some descriptive verbage and fax the insurance letter to me where they deny payment with patient names redacted. I don't have time to redact for you. In a message dated 1/31/2007 9:22:47 A.M. Pacific Standard Time, deadmed@... writes: Hey folks, never ran into this one before. Maybe some of you have. Billed Cigna for a 98941 and a 99211 on an existing patient. Was not re-imbursed for 99211 as they claim that "much like a surgeon does surgery on the same day as the office visit, they don"t get paid for the office visit for that day". Huh??? I hadn't seen this patient in about 6-8 months. I was told i need a modifier that distinguishes 99211 as different and that i must submitt my notes for payment. Isn't 99211 inherently different? This is a bill i submitted in August of 06. The payment was initially sent to the patient (again) even after i specifically mentioned that they have done that in the past and NOT to do it again. Holy incompetance bat man. To take from Oberman: Cigna is today's worst Insurance Company In the Wooooorrrrrrld!!! ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted October 3, 2007 Hi, My son was just diagnosed with positional plagiocephaly w/ facial asymmetry and tortocolis but our insurance provider (Cigna) denied his DOC Band due to exclusion. They will only cover post operatively. Has anyone had any luck with overturning this decision with Cigna specifically? I'm a mess to begin with due to the immense guilt of screwing up my son and now have to go into battle with an insurance carrier... he's just 3 months old... Any help would be greatly appreciated Quote Share this post Link to post Share on other sites
