radiosister
New member
- Joined
- Oct 26, 2017
- Messages
- 1
- Reason
- CALS
- Diagnosis
- 06/2017
- Country
- US
- State
- MO
- City
- St. Louis
I understand your frustration. I handled everything for my husband. I worked hand in hand with the doctor's office, Soleo, Cigna, and a company called Carecentrix that Cigna outsources to for Radicava. Nothing really moved forward with Cigna on call after call, until I uttered the words:
"Do I need to have my attorney contact Cigna to move this claim forward? My husband has ALS, and while your company is giving me lip service, my husband's disease is progressing. Are you discriminating, because he has ALS?"
The Cigna rep went into action, calling several departments, to find out where the breakdown was. The final department was gone for the day, but he set a time to call me the following morning. He was still gathering info, but he called every hour that day with progress reports. He was finally able to determine that Carecentrix was the problem. They were denying all claims because Radicava did not have a code in their system. It took 4 days for that to happen, and everyday I kept calling the same contact at Cigna, pushing. So often, he called me to inform me of progress. I didn't let up, but just kept pushing. Finally, this contact was able to get Soleo, Dr.'s office, Carecentrix and Cigna all on a conference call. Each person stated what they needed, and they worked as a team. It was another 2 weeks, but my husband received his first infusion on 9/27. I felt like I was in the fight of my life to get this done. We have done all infusions, but 1, at home.
He was the 1st person to receive a port at our ALS Clinic , and tomorrow, a nurse from Soleo will be coming to show us how to use it, and he starts the 2nd round of infusions. I chose Soleo because Option Care did not return my call to them, and Soleo has been wonderful. All I know, is the Cigna rep was compassionate, respectful, and truly wanted to help. Searchlight was exactly the opposite. Absolutely no help at all, so go around these people. Call your insurance company, until you find someone that will listen, and if you need to use my strategy, I know it worked!
"Do I need to have my attorney contact Cigna to move this claim forward? My husband has ALS, and while your company is giving me lip service, my husband's disease is progressing. Are you discriminating, because he has ALS?"
The Cigna rep went into action, calling several departments, to find out where the breakdown was. The final department was gone for the day, but he set a time to call me the following morning. He was still gathering info, but he called every hour that day with progress reports. He was finally able to determine that Carecentrix was the problem. They were denying all claims because Radicava did not have a code in their system. It took 4 days for that to happen, and everyday I kept calling the same contact at Cigna, pushing. So often, he called me to inform me of progress. I didn't let up, but just kept pushing. Finally, this contact was able to get Soleo, Dr.'s office, Carecentrix and Cigna all on a conference call. Each person stated what they needed, and they worked as a team. It was another 2 weeks, but my husband received his first infusion on 9/27. I felt like I was in the fight of my life to get this done. We have done all infusions, but 1, at home.
He was the 1st person to receive a port at our ALS Clinic , and tomorrow, a nurse from Soleo will be coming to show us how to use it, and he starts the 2nd round of infusions. I chose Soleo because Option Care did not return my call to them, and Soleo has been wonderful. All I know, is the Cigna rep was compassionate, respectful, and truly wanted to help. Searchlight was exactly the opposite. Absolutely no help at all, so go around these people. Call your insurance company, until you find someone that will listen, and if you need to use my strategy, I know it worked!