Frustrated...What would you do?

[MrsFairFan]

Ok I will try to make this short and simple. As most of you know Fairfan had ankle surgery back in July on his ankle. He went through rehab for months and when it was towards the end of rehab they gave him a muscle stimulator to take home to help with the recovery. Well we have had that thing for forever. I called them about 4 months ago and asked them if I could mail it back that we had never used it and didn't need it. They man told me to wait until I received a bill b/c most insurances cover it. Well apparently our insurance co. didn't cover it and I got a bill in Dec.

 

I called them 3 times at different times and never got an answer. Then last month I got a VM of a person and played phone tag up until today. I talk to her and she tells me that its no longer returnable now that I have received a bill. UMMM EXCUSE ME. She then sends me to a man named Patrick who tells me its too late and I needed to call when I got an explanation of benefits from our insurance stating they wouldn't pay, not wait till now. I am livid. Our bill for an item we have never used and are willing to send back they will not take back and its $1500.00. I told them I wanted it out of my hands but I wouldn't pay that b/c one we never used it and 2 I did exactly what they told me to do. He told me if I returned it now I would still get charged for rental of 5 months. ( that would be more than what we owe for the item) WHATEVER. I am livid and not sure what I am going to do. What would you do? And be honest I am torn here.

[woodsrider]

I don't suppose you got the name of the person you talked to 4 months ago did you?

[hja1224]

I would call Howard Ain (sp?)... or any of the investicative reporters at your local news station. A lot of times they are able to fix these things. I hope it all works out for you.

[Birdsfan]

Did you actually receive an EOB denying the claim. If so, when?

[MrsFairFan]

I don't suppose you got the name of the person you talked to 4 months ago did you?

 

I didn't, but you know the funny thing is that when I called and told them I wanted to return it 4 months ago, I swear its the same guy I talked to today. I think he is the returns guy.

[MrsFairFan]

Did you actually receive an EOB denying the claim. If so, when?

 

I can't remember, we got so much during the period with the surgery going on, but I am calling Cigna to get another copy. Why do you ask?

[Birdsfan]

I can't remember, we got so much during the period with the surgery going on, but I am calling Cigna to get another copy. Why do you ask?

Having dealt with somewhere near a trillion medical billers, I would venture to guess that someone screwed up somewhere along the line.

[MrsFairFan]

Having dealt with somewhere near a trillion medical billers, I would venture to guess that someone screwed up somewhere along the line.

 

I just don't understand why they can't take it back. We never used it. He is saying we will owe one way or the other, when really they just want their money lol. He even said I could sell the item or donate it to a local rehab center and write it off as a tax write off. Are you kidding me? Who says that? All to get me to pay that bill. WRONG!!!!

Edited February 4, 2009 by MrsFairFan
Fixing a word

[Birdsfan]

I just don't understand why they can't take it back. We never used it. He is saying we will owe one way or the other, when really they just want their money lol. He even said I could sell the item or donate it to a local rehab center and write it off as a tax write off. Are you kidding me? Who says that? All to get me to pay that bill. WRONG!!!!

It's durable medical equipment and once your rental fees exceeded the cost of the item -- in their eyes, at least -- it was yours. Obviously, they don't want it back, because they already have the money in their pockets.

 

I'm surprised that Cigna wouldn't pay for medically necessary equipment. That's why I think someone submitted the claim incorrectly. If the claim really was denied, here is what Cigna suggests you do to appeal the decision:

 

1. Call Member Services.

 

2. If Member Services cannot resolve your concern/complaint regarding a coverage decision, ask the representative for information about how to appeal the decision.

 

3. If you are not satisfied with the first-level appeal decision, we will provide information on how to request a second-level review.

 

4. Depending on your benefits plan, additional independent review of coverage decisions involving issues of medical necessity or experimental treatment. You will be notified in writing as to what type of review is available to you.

[MrsFairFan]

^ If we don't need it now but needed it then, do you think they will respond this late, and change it?

[woodsrider]

I just don't understand why they can't take it back. We never used it. He is saying we will owe one way or the other, when really they just want their money lol. He even said I could sell the item or donate it to a local rehab center and write it off as a tax write off. Are you kidding me? Who says that? All to get me to pay that bill. WRONG!!!!

Did you or FairFan sign anything when you orignially got it? A contract or agreement of any kind.

[MrsFairFan]

Did you or FairFan sign anything when you orignially got it? A contract or agreement of any kind.

 

Yes. All it says is that you take full responsibility for it once it left the office. And we have done everything we were supposed to do, but given wrong info at time of return. They are denying that they told us that...which is the frustrating part.

[MrsFairFan]

The weird thing is that our insurance will cover experimental injections for lubrication in the ankle, but they won't cover a stim machine that they use in the rehab center every single day,

[Birdsfan]

^ If we don't need it now but needed it then, do you think they will respond this late, and change it?

If it was a bill that they should have paid, I don't see why not.

[MrsFairFan]

If it was a bill that they should have paid, I don't see why not.

 

So maybe I should contact Cigna over this issue now, is that what you are saying?