Get What is legally yours (Appeals Committee Review Meeting)

Discuss here about Medical Disability claims and Insurance possibilities for PN treatment options
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kat
Posts: 203
Joined: Fri Sep 17, 2010 3:44 pm

Get What is legally yours (Appeals Committee Review Meeting)

Post by kat »

Cigna Health Care

As you know, you have 3 tries to win an appeal for services.
We also know insurance companies are instructed to turn us down the first 2 times in beleiving we will give up the fight for the money that is ours.

Cigna always gave me my money on my first appeal.
However, for the first time, Cigna denied my 1st appeal and I gathered my pile of medical papers and sent in my second appeal.

CIGNA ENDS ONE LETTER stating they will have an Appeals Committee Review Meeting and that they will contact me with when and where.

CIGNA NEVER CONTACTED ME and I called 2 times a week for the 4 weeks they had to give me an answer on my second appeal.
Finally, I was verbally told I was denied my second appeal without being informed of the Appeals Committee Review Meeting.

I called again, talked to a manager and stated I DID NOT WANT TO GET MY LAWYERS INVOLVED.

My second appeal was REOPENED and I GET TO SCHEDULE THE APPEALS COMMITTEE REVIEW MEETING WITH MY DOCTORS ON THE LINE!!

Please don't get tricked out of your legal rights when appealing.
This was a dirty trick and I am so glad I was parsistant in demanding my rights.
Born with pudendal and obtorator neuralgia. 32 years of being misdiagnosed.
Surgery with Conway 7/14/10. Internal burning cured!
Currently in PT for many pelvic floor issues due to having PN for so long.
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Violet M
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Joined: Mon Sep 06, 2010 6:04 am
Location: United States
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Re: Get What is legally yours (Appeals Committee Review Meet

Post by Violet M »

Wow, good for you, Kat! I went through the entire appeals process with Cigna and was denied for coverage of my surgery so I understand how nasty they can be. Good luck with your appeal. Would love to hear about it, especially if you win! ;)
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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