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Hi there.
This was quite a long time ago (in 2000), however we were denied, by CIGNA and won on appeal. We were denied by Cigna for three things:
"The request has been denied due to lack of conservative measures like Postural Therapies, and the abcense of Craniostosis or any other Neurological abnormalities. This is considered cosmetic and as such is not a covered benefit. If you choose to proceed with this plan of treatment, you will be financially responsible for all related charges."
(this was straight from their letter, including misspellings)
I used a lot of the things you probably already have from the files, but I can give you more information about what I did to get the denial reversed if you are interested. Feel free to email me off list tnt@isoc.net
Tracy
Mom to Quinn, born 11/99, DOCband graduate 10/00 for scaphocephalic (long/narrow) head shape.
>------- Original Message -------
>From : toddbusot[mailto:
>Sent : 1/15/2008 12:11:15 AM
>To : Plagiocephaly@
>Cc :
>Subject : RE: [Plagio] Cigna Insurance Claims
>
>Greetings. I am new to the group but have been reco'd by a coworker to
see if someone out there can help. I currently have Cigna PPO and went
through Cranial Tech (CT) to have my (then) 8-month old son fitted for
a DOC band. Was told up front that Cigna is notorious for not covering
this procedure, but I figured a) my son needs it! and b) worst case, I
will appeal any denial.
Well, long story short, the date of service was in May, 2007 and I am
finally being 'officially' denied. I write it that way b/c it took
numerous phone calls, thus numerous different answers, to finally get
an answer that the band was denied.
Does anyone out there have any success stories to share with going
after Cigna for re imbursement? I have some excellent articles and
medical journal reports, but didn't know if there was someone who could
help with some pointers about how to go about this.
Any help is much appreciated. Thanks.
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