Cigna starting patients on CPAP by just sending box

[Hoser]

This article http://www.sun-sentinel.com/business/lo ... -headlines

explains that Cigna, thru Gentiva, thru Rotech is just shipping CPAP to patients and skipping any Respiratory therapist interaction with patient. Does anyone have direct experience with this? Is it good or not?

[LDuyer]

Hopefully someone can answer your question.

I can't because I haven't gotten my first machine yet. The doctor says they will be dealing with my insurance. My insurance is Cigna, so thanks to your concerns, I'll be sure to ask more questions. The article, while it seemed to be discussing diabetic pumps, unnerved me, since I have Cigna. Hope they don't try that stuff on me. Thanks for reminding me to pay more attention to this process.

Sincerely,

Linda

[wading thru the muck!]

I don't know.

After some of the bad stories I've heard about the DME Apria (the cpap DME who refused to just send cpaps to cigna's customers) I think I'd rather have someone just send me a machine as long it was the one I wanted.

Come to think of it that is what I did do!

The best situation would be for the local DMEs to charge fair prices and give good service. Even when it is "THE INSURANCE" paying, it still all gets rolled into the high premiums you pay.

[GumbyCT]

Does anyone have direct experience with this? Is it good or not?

Yes, I do. 1st let me say I could not read the linked article because it is no longer there. It is a good idea to paste even part of the link for that reason.

But yea I received my 1st CPAP unit from Cigna via Apria via UPS. No UPS is not very good at setting these things up, in fact he didn't. The CD that came with mine was scratched and would not work. That was my 1st experience w/Apria - I called to let them know the CD wouldn't work, the lady said she didn't know what to do and someone would call me back.

I was hoping she would just give me a link to something online. But no - someone will call back? Well that was Jan. 31, 2007 - NO call as of this writing. Should I stop holding my breath?

So you mean Cigna is part of the problem? All this time I was blaming Apria cuz they also sent me a data capable auto a few months later - just in a box. No Manual, No Instructions, No Humidifier, and NO idea just how long I would have it.

Then one day - out of the blue some guy calls and says "I'm will be in your area tomorrow, so I will be picking up the loaner machine". hmmm - Oh really? Isn't that burglary? I'm on vacation with it so good luck.

I guess if Cigna contracts Apria - yea they are part of the problem and certainly not part of the solution.

No I don't think it is a good idea for any 1st time user to even try this by themselves. It took weeks before I found out I wasn't even wearing the right size mask - no wonder it kept leaking!!

No I don't think it is a good idea but it must be cheaper.

[glassman]

Yes, this happened to me. I have Cigna and they told me that Apria is the sole DME. I thought that I was going to get an appointment and somebody would explain it all, but a box just showed up at the front door one day (tank style Respironics with humidifier). I watched the video and set things up. Maybe a week later, I called Apria and they told me to just come in anytime to see a respiratory therapist, which I did. The policy has changed since then, and now I have to make an appointment. I have been there three times now (once to pick up a BiPap which apparently they want you to pick up rather than sending it via UPS).

[fidget]

Cigna IS the boss. We don't even know that someone has been started on CPAP unless we get a phone call from the patient.

Apria is simply the equipment supplier for Cigna, which directs care. I can't even change your mask for you without an auth from the Cigna referral center, even if you're sitting in my office bleeding from yours.

EVERYTHING from wheelchairs to nebulizers to CPAPs have to be referred and approved by the Cigna referral center.

And just so you know, their reimbursement for that equipment is about what you pay on CPAP.com.

They provide our health insurance too, so I know what a pain it is.

Corporate America holding each other's hands and we the people have to dance to the tune they play.

[GumbyCT]

I have been there three times now (once to pick up a BiPap which apparently they want you to pick up rather than sending it via UPS).

If you tell them it is tooo far to drive - they can/will male it. ha

[Perchancetodream]

You'd think Cigna would learn!

http://www.signonsandiego.com/news/stat ... plant.html

GLENDALE – At 17-year-old Nataline Sarkisyan's funeral Friday, no one mentioned the insurance company that denied a potentially life-saving liver transplant and then reversed the decision hours before the girl died.

...

The day before this Thanksgiving, Nataline received a bone marrow transplant. She later developed a complication that caused her liver to fail.

Philadelphia-based Cigna Corp. initially refused to approve a liver transplant, calling the surgery an experimental procedure that was not covered by the employer's benefit plan. Nataline was covered under the policy of her father, an automotive technician for Mercedez-Benz of Calabasas, said her father Krikor Sarkisyan.

Four doctors appealed to the insurer to reconsider in a Dec. 11 letter. The doctors said patients in similar situations who undergo transplants have a six-month survival rate of about 65 percent.

After a crowd of nurses, community members and family friends picketed outside Cigna's office in Glendale, the company reversed the decision. But by this time, it was too late and Nataline died.

Cigna, which has revealed little since Nataline's death, said Friday its role was to manage the employer's self-funded benefit plan. Under such arrangements, Cigna is paid an administrative fee to process claims and perform other duties on behalf of the employer, who carries the risk and pays for procedures.

In Nataline's case, Cigna determined the liver transplant was not covered under the employer's plan because it was considered experimental based on consultations with an in-house transplant expert and two independent doctors specializing in organ transplantation and leukemia.

Cigna decided to make an exception for Nataline “given our empathy for the family and the unique circumstances of this situation,” said Dr. Jeffrey Kang, Cigna's chief medical officer.

“We volunteered to pay for it out of our own pocket. We decided to ... bear the risk even though we had no obligation to,” Kang said.

Attorney Mark Geragos has said Cigna “maliciously killed” Nataline because it did not want to bear the medical expense of the procedure and aftercare. Geragos said the family will file a lawsuit after the funeral.

...

[roster]

...
The day before this Thanksgiving, Nataline received a bone marrow transplant. She later developed a complication that caused her liver to fail.
....

While we are pointing fingers, let's go after the doctors and hospital that botched things to start with.

[Perchancetodream]

Rooster, it may be the fault of the doctors or the hospital, but the bottom line is that as long as insurers like Cigna keep generating this type of publicity Americans will find socialized medicine more attractive.

So when does a liver transplant stop being "experimental?" and is that a decision that an insurance company should be making. Isn't there an obvious conflict of interest?

Cigna pairing up with Apria gives me the willies. I am so grateful that my husband spent 27 years in the Marine Corps and that we don't have to deal with either.

Susan

[roster]

........... as long as insurers like Cigna keep generating this type of publicity Americans will find socialized medicine more attractive.
........

That poor young girl would not have been denied a liver transplant under socialized medicine. She would have had time to die several times while waiting years for a transplant.

[vrgsph]

This happened to me. I had Cigna insurance. I had my sleep study in the fall of 2004. In mid January of 2005, I got a package on front steps. It contained my cpap, mask, accessories and a bag. I got nothing else.

To this day, my doctor does not have my sleep study or has ever talked to me about OSA. I found my sleep lab address and phone and called them. They are currently working on pulling my records from cold storage.

The Cigna experience was so bad, I have purchased all my supplies and masks out-of-pocket since then.

I now have new insurance and am working with a DME in town to get new stuff. I told the DME that I will pick the parts or either I go to an online store and buy it out-of-pocket. So far, they are saying I get what I want -- they told me to make sure the doctor writes Auto Cpap and all should be fine.

We'll see.

[Hoish]

I had exactly the same experience. Actually mine was worse. The doctor who got the sleep study results did not give any follow up. He wrote the script for the cpap. Cigna and Apria processes the order and shipped a basic cpap. I did get a message telling me the machine shipped. No choice of machine or mask. No discussion. No education. The box just showed up.

I got a copy of my study. A copy of the script. I have purchased an apap and masks the way I want.

Apria is calling all the time now asking me to call. Sorry their fired.

Jim

[le_wif]

Well, my husband had a different experience with Apria--a very positive one! Once his sleep study was completed and he was officially diagnosed with "severe OSA", they had him in their office in a matter of days to fit his mask and get him started. At that time, we hadn't found this board, so he ended up with a basic CPAP. The good news is that he adapted very well to it and has seen remarkable improvement. Since he feels that he is doing fine (and is compliant) he doesn't feel a need to ask for a better/different machine. (Though I'd like him to, but that's another story).

His experience with Apria has been excellent--they had him try on a number of different masks with his machine, and he picked the one he thought he'd like best. It worked out fine for him. When he got his first cold a few weeks after starting therapy, I called the Dr. and asked for a full face mask, they wrote a script and he went in and tried on a few of those and again, came home with the one that he liked best. It's worked out fine. Anytime we've called with a question, we've had a return call that was professional and prompt and friendly. I guess we've just been lucky, but apparently each Apria "office" is different. I usually try to write in with our experience when there's a rash of "Apria Bashing" so that folks can know that there is SOME hope! I'm sure that some of these offices have earned their bad reputation, but ours is fine.

Le_Wif

[GrizzlyBear]

Hiya, folks.

I come from a country with a partially socialized health care system. We have been under pressure from economic conservatives for years to 'Americanise' or 'privatise' our system, but fortunately it has been slow progress. Our system is FAR from perfect, but the level of protection for low income people is better than many other countries. I doubt that that young girl would have suffered her medical problem here - but of course one can't be definitive.

I am surprised that you tolerate the kind of non-service you get from some of your insurers - not that I should speak, as I am constantly whingeing about our system here (but then, perhaps I'm just what us Aussies would call a 'whingeing bastard').

My own feeling is that at least SOME governmental or 'social' involvement is necessary to protect the rights of those involved with the system, because we can't depend on profit-hungry corporations to look after our rights adequately. What the balance is, is of course, the major issue - the English socialised health care system has a reputation for incompetence. However, our own system, while it has its faults, does seem generally quite good. Except for those changes that have been made over the last 20 years to 'privatise' the system.

Regards (I've got to run and pick up our Mexican takeaway dinner, or I'll get my bum kicked - so this is a VERY rushed message)

GrizzlyBear