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RE: [IP] Cigna upheld the denial

 --- On Fri 10/17, Kathleen Weaver < email @ redacted > wrote:

 From: Kathleen Weaver [mailto: email @ redacted]To:
email @ redacted: Fri, 17 Oct 2003 17:46:56 -0500Subject: [IP] Cigna
upheld the denialJust got a letter from Cigna and they have upheld the denial of
my pump forthe following reasons:Based on information submitted the medical
necessity for an Insulin Pump wasnot established.Clinical information provided
does not establish the medical necessity forthe requested insulin pump. Clinical
records provided do not documentconservative changes in insulin doses to modify
control. No referral toendocrinologist to assist with managment. Non-certified
Insulin pump.Fun, isn't it?
 Kathleen, Did your primary care know that you needed to go to endo to get a
pump? Was an endo available to even go to? I would fight it from that angle.
Don't give up...keep at them. The squeakier you get, the more likely they will
give up and approve it. Call and ask for your case manager and make sure that
you have everything funneled thru that person. Keep at them. This is precisely
why I despise Cigna! My file with them, when I had them, had to be 3 inches
think and marked with a big red x...saying *this woman is a WITCH to deal with*,
LOL. I just would not give up. I would call and talk to supervisors, taking
names, and then to their supervisors, getting their names, and if I had to I
would go up another level. Document every phone calll, every letter, and if
necessary, cc the Insurance Commissioner. They HATE seeing that at the bottom of
a letter. Makes them extremely nervous. Fight this denial. You don't have to
take this no as final. Liz

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