Ditto to Danyell's post -- I have used a case manager for getting approval on a specific item, it did help.
We are currently battling with Cigna about a vest as well. My daughter's PFT's are also good and have increased since using the vest. We have been denied and Hill-Rom has filed an appeal. They did all the leg work on getting another letter out of the doctor to "beef up" our case. No word back yet, but it's only been a couple of weeks.
From what we can tell right now, Cigna's problem with purchasing the vest is they didn't see why she couldn't use the flutter or acapella. She cannot use either of these because they make her dizzy.
Also, does your daughter have reflux? Hill-Rom told me that it is almost impossible for an insurance company to be able to deny if the child has reflux because many of the manual CPT positions have to be done in a head down position -- it isn't safe. That's just one more thing for putting into a letter of medical necessity if it applies.
We are currently battling with Cigna about a vest as well. My daughter's PFT's are also good and have increased since using the vest. We have been denied and Hill-Rom has filed an appeal. They did all the leg work on getting another letter out of the doctor to "beef up" our case. No word back yet, but it's only been a couple of weeks.
From what we can tell right now, Cigna's problem with purchasing the vest is they didn't see why she couldn't use the flutter or acapella. She cannot use either of these because they make her dizzy.
Also, does your daughter have reflux? Hill-Rom told me that it is almost impossible for an insurance company to be able to deny if the child has reflux because many of the manual CPT positions have to be done in a head down position -- it isn't safe. That's just one more thing for putting into a letter of medical necessity if it applies.