It's so nice when rhetoric isn't empty, if you can call it that. My previous post was a bit rough and rushed...not as smooth as I'd like it..but hey at least I got something out. I am most in the mood to post while at work or right after work. I'm not getting paid to blog, so I won't be doing that at work and lately we've been into overtime every night, so I find my energy drained by the time I get home...plenty to say..but no energy to say it without it coming out like crap.

So back to that rhetoric........it turns out I under-analogized with the whole "swords drawn" bit. Their first move after compiling the case paperwork and reviewing it was to send a letter to Cigna and my employer that was the anthrax-laced equivalent of "cut the crap." So we have Cigna going from sitting back, having a good laugh while toying with us for months to "Sir, yes, sir. Our error, sir. Right on it, sir"the very day they got the letter. It helps that my employer is breathing down their neck now, too. So as I sit here now, we are due for surgery approval any day now.

It appears hearing aid contract language was applied to the request for authorization by Cigna, to which they denied service. The problem with this "error" is the paper work submitted by the Implant Center clearly points out the request is not for a hearing aid and that a hearing aid is not beneficial to the patient. This should remove any attempt to mis-label the request as being for a hearing aid. Never mind the fact that Cigna hasn't given a straight answer on any of this since the claim was submitted last year. Let Them Hear did exactly what was needed in the first place that Rochelle at AB wouldn't do, let Cigna know that we aren't going to play games with them. This actually could have all been resolved last year, but I'm thankful, considering the length of delays others have experienced. I will say to anyone reading this that currently has Rochelle working on their appeal to drop her before she wastes another moment of your time. I had been told she was a "miracle-worker" when it came to these things.....she was miraculously apathetic for an implantee doing such crucial work. Let Them Hear cuts to the quick with a passionate approach, don't accept any less.

This is all it took:

Dear Correspondence Representative,

The Let Them Hear Foundation is a 501(c)(3) non-profit based in East Palo Alto, California. Our mission is to assist hearing impaired individuals in accessing technology and medical services they need to maximize their personal development.

We have been requested by David to assist him with resolving his request for receiving a cochlear implant. A copy of the authorization for this representation is attached to this letter.

CIGNA Health insurance company alleges that there is a cochlear implant contract exclusion in Connecticut General Life Insurance Company’s group health plan. However, David’s employer has informed him that there is no such exclusion in his group health plan.

In short, we request that CIGNA inform us of exactly where this supposed cochlear implant contract exclusion is in the employee’s plan booklet so that we may proceed with the necessary appeals process.

Please be advised that blanket exclusions of all cochlear implantation in group health insurance contracts are illegal under the EEOC as interpreted by the ADA. This applies regardless of whether the plan is self-insured. Furthermore, there has been a specific finding by the EEOC that both the employer and the 3^rd party claims administrator are jointly and severably liable for all damages to the insured resulting from the illegal exclusion. As a result of Let Them Hear Foundation’s insurance advocacy, several Fortune 500 companies including Apple Computer, United Parcel Service, and Clear Channel have dropped virtually identical illegal cochlear implant contract exclusions previously contained in their insurance plans.

We've got the right to choose and
There ain't no way we'll lose it
This is our life, this is our song
We'll fight the powers that be just
Don't pick our destiny 'cause
You don't know us, you don't belong
We're Not Gonna Take It - Twisted Sister