Whats maddening? This is maddening. And people wonder why I am half bonkers. Addie NEEDS a shower chair. She cant sit in a tub unassisted, she will drown. She cant stand in the shower unassisted, she will fall. I cant support her 63 pound soapy, slippery body in the shower, I will fall. Addie has 2 insurances, a policy covered by her dads benefit at work, Cigna. Durable Medical equipment is a covered benefit. She also has a state funded insurance partly funded by medicaid,called MercyCare. Her Physical Therapist appropriately wrote a recommendation and we put in an order for a shower chair. Theres no jacuzzi attached to it. Its a simple plastic and woven mesh chair with a belt. No bells, no whistles. (outrageously overpriced, btw) Submitted to Preferred HomeCare (the contracted vendor for such things via the state of AZ and Childrens Rehabilitative Services). The order was sent to Cigna and we received a letter of denial. Cignas policy directive is that it is a luxury item and not deemed a medical necessity. (Should I fall and either of us break an appendage, THAT would be covered, because that would be an accident.) I faxed the denial to Preferred. Preferred just called and said because they dont participate with Cigna, they cant forward the order to Mercy Care (her secondary). The law enforces using the primary insurance first. CareCentrix, who would fulfill the order doesnt participate with MercyCare/medicaid. Do you see what has just happened?
Posted on: Fri, 03 Oct 2014 18:58:39 +0000
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