Anyone have Cigna?

ejdischer · Post by **ejdischer** » Sat Feb 03, 2007 3:21 pm

I have Cigna here in Connecticut. They tell me I HAVE to use Apria. Yet for some reason when I go on their website and look up DME in Cigna's provider lookup, many different providers come up in their directory. I'm just wondering if I HAVE to use Apria. Apria is impossible. They always tell me they can't get the mask I want. I went through it with the Hybrid, and now I'm going through it with the Opus. They never call me back either. I called over a week ago to get a new mask since the Hybrid isn't working for me. They told me Cigna doesn't have a restriction to how many I can get, but I have to come in for a mask fitting. Still no call to schedule a fitting after over a week.

Also, has anyone bought from CPAP.com or somewhere else and submitted to Cigna with any success? I'm thinking with masks it would be easier to just purchase it and submit. Thanks.

EJD

roster · Post by **roster** » Sat Feb 03, 2007 4:35 pm

I have a Cigna policy and they used to say you could only buy from Apria. I talked to Cigna recently and the lady said look at the web site because they have added some DMEs (cpap.com was not one of them the last time I looked).

My policy pays 100% for durable medical equipment including masks. With Cigna, if you buy it yourself and submit it to Cigna, you run a high risk of never getting reimbursed (this is from experience of my colleagues at work). Best is to find a Cigna approved DME and let the DME get reimbursed from Cigna.

There are some nice things about Apria. One is if they supply you something and then the insurance company refuses to pay Apria bears the cost.

ejdischer · Post by **ejdischer** » Sat Feb 03, 2007 5:18 pm

My biggest issue with them(apria) is customer service. I just don't feel like it exists. The other major thing for me is I'm constantly getting conflicting information from them. Originally they couldn't ge tthe Hybrid. Then they could. Now apparently they will no longer be carrying it.

I want to get the Opus, but I'm thinking they're just going to tell me they can't get them since it's so new.

EJD

roster · Post by **roster** » Sat Feb 03, 2007 5:27 pm

ejdischer wrote:My biggest issue with them(apria) is customer service. I just don't feel like it exists. The other major thing for me is I'm constantly getting conflicting information from them. ........................................

EJD

I have the same experience with them. I have seen this many times in my long business career and each time the root of the problem wasn't the upfront people (Resp Techs and Customer Service staff in the case of Apria). The root of the problem was always the management of the company.

I have a very good personal experience with the local Apria branch manager and the local staff. But they could not execute what they wanted to do for the customer and I could tell they were dealing with some poor management at the corporate office.

ejdischer · Post by **ejdischer** » Sat Feb 03, 2007 5:33 pm

I completely agree. When I first went in, they told me they'd need to order me an M-Series and they'd call me when it came in. Two weeks later I call them back and the person on the phone tells me that it IS a special order but it also requires medical necessity, which I thought was weird. Same with the Hybrid. They wanted to give me one, but they were special order and once anything with Apria leaves the branch, it's really up to you to get it taken care of.

As someone who hasn't dealt with DME's for more than a month or so, I'm wondering if certain DME's just choose not to order certain products for people. I wouldn't mind waiting until 2/7 when the Opus comes out. But if I call Apria, I'm sure they'll tell me it's a mask they can't get. They told me a week ago that the Optilife mask is unavailable. I'm wondering if they just say that because they have no idea they can order it.

EJD

Linda3032 · Post by **Linda3032** » Sat Feb 03, 2007 5:50 pm

OptiLife is made by Respironics. If that DME can't get Respironics masks, then he isn't much of a DME.

Have you tried calling a different DME - one on the list, to see if they can help you?

And just mention to your current DME (as in the manager of the store), that you are considering going to a different supplier. Then see how quick they can get an Opti for you.

Linda3032 · Post by **Linda3032** » Sat Feb 03, 2007 5:54 pm

A bad DME

gives all DMEs a bad name.

bdp522 · Post by **bdp522** » Sat Feb 03, 2007 6:25 pm

According to Apria, they carry all Respironics and F&P masks. So I asked for the Optilife. Now all of a sudden I need an Rx from the MD stating that he wants me to have the optilife. Get the Rx, now they say it's a special order! It will take 2 weeks. That was Jan 24. Any bets on how long it will take?
While I had Apria on the phone I ordered my 2 disposable filters(get and use 2 each month) Guess what...they are BACK ORDERED! How does such a large DME run out of filters for a respironics machine?!? Guess how long it will take for them to come in....you got it 2 weeks.

Brenda

lvwildcat · Post by **lvwildcat** » Sat Feb 03, 2007 9:57 pm

I too have Cigna- I use a local DME company here in Las Vegas. But effective Jan. 1,2007 Cigna has contracted exclusively with Apria. When I called Cigna-they told me that since I was already established with a DME they won't be switching me to Apria at this time.

snoozeandlose · Post by **snoozeandlose** » Sun Feb 04, 2007 5:57 pm

It has always been my understanding that the physician wrote an order for CPAP, but not what brand. I also thought that having a diagnosis of OSA was the proof of medical necessity. I got my mask from Apria through Cigna with no trouble. Now I am waiting for a mask gasket or cushio or whatever they are called. They called me once after my doc office called them, but I lost the message and haven't bothered to call them back and of course they haven't bothered to call me. I have also been told that Cigna only uses Apria. Good luck.

jrc90101 · Post by **jrc90101** » Sun Feb 04, 2007 9:14 pm

As a newly diagnosed (sp?) OSA suffer, I don't know much about DME's. A friend of mine has OSA and Cigna and he's not fond of Apria. I have Cigna and have to use Apria, and I've been waiting for over a month for my machine to come... called them last week and heard 7-10 days, and that they got the order on 1/25. I'll be calling back on Tuesday. I plan to just keep bugging them until I get my equipment.

JC

dw · Post by dw » Sun Feb 04, 2007 11:04 pm

I am new to OSA and also have Cigna. I just received my machine last weekend. The Apria staff have been great so far. Before I could get into their office I was contacted from the Denver office. When I spoke with the local Chicago suburban office the person who answered the phone knew my name, as my doctor wanted me to start as soon as possible with my severity of OSA. This was the same day as I had seen the doctor. My machine came in the next day and I went to the office to go through the details. The man that gave me the "tour" of BiPaps was very easy to work with and informative. Everyone was friendly and let me know to call them at any time. I hope that the relationship continues on this note.
dw

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