Newbie with CIGNA Needs Advice

[dangerousdave]

A week ago I went through the sleep study and during the night they came in and hooked me up to an Omnilab Advanced CPAP. I'm assuming that the doc will prescribe a machine for me when I see him soon. Does anyone who has dealt with CIGNA POS know what I might be in for in trying to get a really good machine? Any tips you can offer for this old guy would be appreciated. Thanks

[Sheriff Buford]

Be sure your doctor prescribes a Resmed S9 Autoset and a mask that meets the patient's requirements. I have CIGNA and have not had any problems. You should be able to get a new mask, hose and 3 filters every quarter. Get your DME (the place you get your equipment from) to reorder for you.

Sheriff

[Diablode]

Insurance pays out the same no matter the machine, it isn't the insurance thats gonna try to screw you, its the DME if your doctor just rights a generic CPAP prescription. You can ask the dr. to be specific about the machine (make sure its data capable so you can keep track of how your doing) or insist with your DME.

[GumbyCT]

A week ago I went through the sleep study and during the night they came in and hooked me up to an Omnilab Advanced CPAP. I'm assuming that the doc will prescribe a machine for me when I see him soon. Does anyone who has dealt with CIGNA POS know what I might be in for in trying to get a really good machine? Any tips you can offer for this old guy would be appreciated. Thanks

I am sure there are a variety of Cigna plans that may have some differences but back in 2007 when I had Cigna they contracted the equipment supplier (DME) to Apria known as the BIG A because of their poor service levels.

It took a month for me to get my machine which came in a box via UPS. I had NO Idea how to put it together, much less use it and the CD that came with it was scratched and did NOT work.

It took me 6 months after that to find this place so you are ahead of where I was. I would encourage you to contact your insurance and speak to them directly to understand exactly how your policy will work.

As mentioned you would do best to have your doc write a make & model specific script or Big A will mail you a brick - a machine which is NOT data capable.

Meanwhile get busy reading here to understand some of the quirks of the sleep business you will be part of AND how you can become your own advocate.

After all, No One cares more about you than YOU!

[Tino2You]

I has my sleep study in April and got my machine mid may. I have Cigna insurance (and yes there are different plans). Once diagnosed(this took the sleep doc two weeks on a drop dead easy diagnosis (84AHI O2 level 85). After that, my doctor faxed the prescription to Cigna.

For my plan they use Care Centrix to handle the cases. CC took a couple of weeks more losing my Rx (twice) among other hassles. During the time from the sleep study till CC handed me over to Apria, I was introduced to this forum. The education I received in here was priceless!

I met with Apria and was told I was going to get a S9 Escape. I told them I wanted a full data capable machine and was told, "This is what your doctor ordered". Apria will lie to your face and have their hand in your pocket all the time smiling sweetly! (Ok that was a generalization...the one near me was that way...I am sure there are good apria locations out there). Sooooooo long story short, I called the doctor from the Apria office and had him FAX over a very specific Rx for a ResMed S9 AutoSet with a lower pressure (5) and an upper pressure (15). And that was finally filled. There is a very good reason to have a fully data capable machine. You can "see" how your therapy is progressing. When I first started, leaks were my issue, it took some tweeks on my mask, some adjustments on machine settings and my AHI numbers are almost always below 3. And I am sleeping comfortably.

Last week, I called Apria for a heated hose (they should have told me about that on the first visit) and was told it was not part of my "package". I asked that I be billed for it and was told they don't do that, I had to go through Cigna. I called Care Centrix (Cinga's gate keeper) and got an order for one processed. Called Apria a week later and was told they did not receive an order (lie). Called CC back and got the order number and when I told Apria the order number I was told I needed a new Rx for the hose (lie). I purchased one from our host.

I called Cinga and got a new DME We will see how FirstChoice works out. My three month resupply will occur in another few weeks. Fingers crossed and hope the creek don't rise

Sorry about the ramble.

[CIGNAQuestions]

Hello,

I would be happy to help you with your questions regarding your benefits. Please send me an email to LetUsHelpU@cigna.com for further assistance.

Thank you,

CignaQuestions

[chunkyfrog]

Bravo, Cigna person.
More insurance/DME's should care enough to find out what we really need.
This forum is a wellspring of information.
Please do not be offended by all the negative reports;
These reach the NET because no one else will listen.
Thank you for grappling with this issue.
Welcome.

[dangerousdave]

Hello, I would be happy to help you with your questions regarding your benefits. Please send me an email to LetUsHelpU@cigna.com for further assistance.
Thank you, CignaQuestions

Thanks for your offer to help. A few days ago my DME called and it appears so far, that between CIGNA, Carecentrix, my DME & my doctor, that my needs are being met. I hope to receive a CPAP machine soon that is what my doctor believes that I need. Thanks for all the kind people that replied here and I'll let you know how things end up for me.

[GumbyCT]

I hope to receive a CPAP machine soon that is what my doctor believes that I need.

That is when & where the fun begins. When the DME tells you your doc wants you to have a brick for a machine.

[dangerousdave]

GumbyCT said "That is when & where the fun begins. When the DME tells you your doc wants you to have a brick for a machine."

My DME called me today to tell me that the Resmed S9 Autoset with heated tube was prescribed for me however, it won't be in stock until this weekend. They asked me if I wanted something else that was in stock and from what I've seen here I don't think that I do, so we'll see.

[GumbyCT]

GumbyCT said "That is when & where the fun begins. When the DME tells you your doc wants you to have a brick for a machine."

My DME called me today to tell me that the Resmed S9 Autoset with heated tube was prescribed for me however, it won't be in stock until this weekend. They asked me if I wanted something else that was in stock and from what I've seen here I don't think that I do, so we'll see.

Watch OUT for the bait n switch. Make sure Autoset is written on that machine.

AND not just for you but always learn how to check the hours on the machine.

Good Luck

[dangerousdave]

I just had a visit from a respiratory therapist from the local hospital (representative of Peoples Home Medical) that delivered and instructed me how to use my ResMed S9 Autoset with heated tube. There was no bait and switch attempted however, the machine took a little longer than expected to get in stock. So I'll try it tonight and see how it goes. Thanks to everyone here for their advice and comments.
Dave

[wilsonintexas]

Keep in touch with this forum, and look into the Sleepyhead software. It lets you look at the data that is collected on the machine. Then you can track how you are doing.

Sleepyhead is a free package, and you will have questions. This forum will help answer them.

You have a nice full data machine, now you need to learn what it is trying can tell you.

Good luck.......

I hope you are one of those that have teh MIRACLE and all goes well from the first night.

If not, we will be seeing more of you..... do not give up, it will get better.....

[brucifer]

I have CIGNA POS, and they have been wonderful with me. Instead of using Carecentrix, I used HomeLink as the in-network clearinghouse, and they set me up with an outstanding DME provider in my area, ExtraKare. I insisted on an S9 Autoset and an OPUS 360 nasal pillows mask, and ExtraKare had no problem complying with my request. My ExtraKAre rep is also a CPAP patient (15 years) and very knowledgeable, so that went a long way with putting me at ease.

Anyway, dave, glad you finally got your set up. Best of luck with it.

[ladyhen]

I have CIGNA POS, and they have been wonderful with me. Instead of using Carecentrix, I used HomeLink as the in-network clearinghouse, and they set me up with an outstanding DME provider in my area, ExtraKare. I insisted on an S9 Autoset and an OPUS 360 nasal pillows mask, and ExtraKare had no problem complying with my request. My ExtraKAre rep is also a CPAP patient (15 years) and very knowledgeable, so that went a long way with putting me at ease.

I've been on my CPAP for about 18 months now and am very happy with my therapy. However, I have moved from NC to GA and now have Cigna Open Access PPO for insurance. I called today to see about getting set up with supplies because I've been using stuff I had set aside from NC and it's time for a new mask, etc. Called Cigna and they gave me the number for CareCentrix.

I'm in the Atlanta Metro area. Do you think I can go through HomeLink as well?