CIGNA had to PAY!!

Finally a little bit of good news!  Cigna had to pay for my gallbladder ultrasound!  When i started this journey, Cigna's website and member service's personel told me that ViaChristi in Wichita was an in-network hospital.  This was good news since ViaChristi is the only hospital in Wichita that will be doing the lapband! A month or so ago, I went to ViaChristi for the required gallbladder ultrasound.  On May 16th, all my paperwork for surgery was turned into Cigna for approval.  I've been approved for surgery, but Cigna was now saying that ViaChristi is out of network.  When checking my claims on the website, sure enough, I found that they hadn't paid a dime for the ultrasound....claiming out of network. To make a long story short, I raised hell.  I talked to a dozen or so people from Cigna, all of whom verified info that ViaChristi was in-network.  I made copies of the website page that showed their listings of providers.  I documented the conversations, names, date, times.....and let them know at the end of the conversations that I wanted them documented and on the record for future reference.  I called and complained to our employer's benefits specialist.  I filed a complaint with the Kansas Insurance Commission.   I tried to access Cigna's website the last couple of days.  It was down for maintenance.  Finally today, I was able to get on.  To my surprise, the claim for the ultra sound now is showing paid at in-network benefits!!!  I also received a phone call this afternoon from our employer's benefit specialist....verifying the same thing.  I received a letter in the mail from the Insurance Commission verifiying an inquiry to Cigna on the complaint.   Well....after the website update, Cigna is no longer showing ViaChristi as a participating provider.  And as far as getting my surgery done at ViaChristi...it's a no go because the information has all been corrected PRIOR to my surgery.  I am now going to have my lapband done at LivLite in Junction City. At least Cigna had to fork over the benefits for the ultrasound!  Chalk one up for the little guys!  Several hundred dollars may not be a big deal for the insurance sharks....but for me, it's a very big deal!!!!

Well, even though it isn't necessarily the outcome you had originally hoped for, I am glad you were finally able to get things straightened out.

& KUDOS ON GETTING THEM TO PAY FOR YOUR ULTRASOUND!! WTG!!

Best wishes with your surgery

Hugs

Donna