Monday, September 21, 2009

Update

Here's a quick but promising update.

After emailing the hubs' HR benefits coordinator last Thursday (on the guidance of a great resource I got from an amazing friend), our Cigna Care Advocate contacted me on Friday afternoon. She said she had received the information about what has transpired with my referral from the HR person and that she was pulling all the research. She was so kind and sympathetic and really seemed determined to get to the bottom of this nightmare. She said she wanted to spend the rest of Friday and this morning gathering info and that she would call me by 2 p.m. today.

Well low and behold someone stayed true to their word and she actually just called me at 1:30! She has gotten all the information from our IPA and all the appeals paperwork that I have submitted from Cigna. She just needs me to fax the letters I have from the doctors and then she will present this to a Case Manager in the next day or two.

She said this shouldn't have gone on this long and she kept apologizing. She said this is a clinical issue and a network adequacy problem -- meaning this isn't an elective procedure and that because they have nobody in-network with the skills or tools to perform it then in theory they would need to provide me with someone who does. These are her basic words.

Now I know nothing is for certain, but I am getting a little more hopeful that these people are finally going to see the light and that we might actually get the resolution we've been waiting so long for.

Please, please keep your fingers crossed and good thoughts going that this bit of info holds true and that what the Care Advocacy woman believes is actually what Cigna will deem correct.

I'll post with any new news as soon as I have it. Until then, say a little prayer...

1 comment:

Jen Hodson said...

My fingers, arms, legs and toes are all crossed for you Al!