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Re: [IP] Cigna upheld the denial


CIGNA was the insurance company that my employer used to have.  They paid for 
100% of my pump cost, had no real problems getting it.  My CDE worked with my 
PCP to get all the paperwork done.  I had chosen Disetronics (1999), was 
 contacted by Disetronics who said they did not have a contract with CIGNA but
would be able to get a pump to me and supplies through a supplier.  Wasn't 
 long before I received it; had to use CIGNA's durable medical manager, Gentiva,
to get all the supplies.  Gentiva was wonderful to work with.


In a message dated 10/17/03 5:47:53 PM Central Daylight Time, 
email @ redacted writes:
Just got a letter from Cigna and they have upheld the denial of my pump for
the following reasons:

Based on information submitted the medical necessity for an Insulin Pump was
not established.

Clinical information provided does not establish the medical necessity for
the requested insulin pump.  Clinical records provided do not document
conservative changes in insulin doses to modify control.  No referral to
endocrinologist to assist with managment.  Non-certified Insulin pump.

Fun, isn't it?
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