John FitzmayerLoganville, GA, United States
Sep 6, 2014
So after a roller coaster of a day yesterday, hearing that CIGNA agreed to pay, then they didn't, then it was someone else. Here is the scoop as much as I can understand it (which is not much).The city I work for is self insured, but use a re-insurance?? for certain procedures (generally when the cost for a procedure is high, like a cochlear implant), then an insurance company (CIGNA) picks up the cost or provides access to the doctors and the hospitals. For all of Nikki's previous procedures that cost enough for the re-insurance to provide for, we had to request for coverage before the procedure. Prior to the cochlear implant we did not have any major issues. With the Cochlear Implant, CIGNA is saying that the request for services has to go through a company called Med Watch. Med Watch is a company used by CIGNA to determine medical necessity. (they previously denied the medical necessity for Nikki's Cochlear Implant when asked by CIGNA). So all of the information that had been sent to CIGNA has now been sent to Med Watch. (this of course all occurs without the knowledge of the patient or the family). CIGNA is saying that they mistakenly processed the original request for the Cochlear Implant in the wrong manner. (would have been nice t know this 5 months ago). This is the best information I have, and if anyone can make sense of it please let me know. Now we are just hoping that the request is sent to the right people, who knows. In the meantime, please continue to share this story with everyone. It is what thousands of families go through each year, for no reason. What a waste of time, resources, and money. Below are links so that this story can be shared with others.
https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809
Share the petition on your Facebook page: http://on.fb.me/1uCpXTS
If you're a Twitter user, click this link to tweet your support: http://bit.ly/1wb4vGN
One more thing, Nikki made the front page of the Walton Tribune!, She was very happy to see her picture on the front page.
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