ComplaintsforCigna
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Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
06/14/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
My son got braces on 05/20/2021. I had 2 processed claims from Cigna back in November of 2022, saying they paid the orthodontist for my son's braces. I was in the orthodontist office 03/20/2023 and they confirmed they have not received any payments from Cigna for the claims. I forwarded them the 2 EOBs I had so they could reach out to Cigna and get their money. After they called Cigna they placed my son's claims back into a pending status saying they needed more information and a new agent must have processed the claims in error and they would be processed within 10 business days. Three months later and the claims still have not been processed, saying they just got the information on 06/01/2023. The claim they did process on 05/26/2023, the orthodontist still has yet to receive any funds for and when they call they have no record of it being paid. They keep telling me they need documentation that my son's secondary insurance isn't primary and I have provided them this information several times. I have also given them copies of court documents showing I have custody of my child and I am to carry insurance on him, which makes Cigna his primary insurance since it is my employer insurance. It should not take over 2 years to pay a claim. My other son received braces the same day and they paid all of his claims with no questions asked.Business response
06/28/2023
June 28, 2023
Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404
Customer: *************************
Tracking ID: **********
Dear Sir or Madam:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.
Sincerely,
**********************************
Senior Manager, Executive CorrespondenceCustomer response
07/07/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Regards,
*************************Initial Complaint
06/09/2023
- Complaint Type:
- Billing Issues
- Status:
- Resolved
I filed a claim for an injury that occured January 1,2023 Claim #********** I have given the company all of the supporting documents and phone numbers to reach the providers of service. This is a claim for supplemental accident insurance. I have logged over 12 hours in phone calls to their ************** claims number and been told I'd be called back dozens of times.No one will give me any response to my claim other than that it's processing and claims typically take several weeks to process. It has been months with no attempt from them to resolve this matter.Business response
06/27/2023
June 27, 2023
Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404
Complainant: *****************************
Tracking ID: **********
Dear Sir or Madam:Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.
Sincerely,
**********************************
Senior Manager, Executive CorrespondenceCustomer response
07/06/2023
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
Complaint: ********
I am rejecting this response because: I filed a claim in January and they just sent me a request to file a new claim today. They're totally disregarding my original claim and forcing me to file a new one and gave me a deadline or they would cancel the claim after Ive waited months to receive a response.
Regards,
*****************************Business response
07/21/2023
July 21, 2023
Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404
Complainant: *****************************
ID: ********
Dear **************:
We can confirm that the letter with the new claim form was sent to ****************** on June 22, 2022. Cigna did not receive ******************'s BBB complaint until June 26, 2023, and at that time Cignas Supplemental Health Solutions (SHS) began their investigation into the matter.
********************'s claim was missing necessary information. We can confirm that a representative with SHS outreached to ****************** on July 10, 2023, in order to obtain the necessary information.
We can confirm that the claim was adjudicated, and a check was released to ****************** on July 14, 2023.
Sincerely,
Cigna's Office of Senior Leadership EscalationsCustomer response
07/25/2023
Cigna has reached out to me and resolved this matter.Initial Complaint
06/08/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
Incorrectly denied claim. I've spoken with numerous representatives and supervisors. After posting a review on ********** a person from PR contacted me. Her research indicated that the plan contract language was clear that the claim should be covered. (When I spoke to *** with a customer service person the *** person was using the wrong contract. I have spent hours on the phone going in circles. It is by design.) She sent it back to *** who had incorrectly denied it three times. Weeks have passed with no action. This is a common pattern where Cigna folks are looking into it, get no where, then drop it and nothing gets done. I would like this claim covered, that is processed correctly.Business response
06/26/2023
June 26, 2023
BBB
1411 K St. NW, 10th Floor
Washington, DC 20005-3404
Re: Customer: *************************
Dear Sir or Madam:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office, of the outcome, upon completion.
Sincerely,
**********************************;
Senior Manager, Executive CorrespondenceCustomer response
07/07/2023
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
Complaint: ********
I am rejecting this response because: I cannot tell from the response from Cigna 9see: above) what they are doing. Who is the complainant? This morning I received a phone call from the Satisfaction department. They are understanding the problem and are now harassing my physician. The problem is that I was not given correct information when I called about the payment amount for my provider, i.e., doctor. The wrong information is, the amount paid for the claim, is incorrect on My Cigna.com. I haven spoken with multiple Cigna employees with the same question that is, Is the omen on Cigna.com for this claim being sent or has it been sent to my physician. I was told yes by more than one Cigna employee. After too many phone calls I am told this morning a completely different version of what the problem is. So, getting clear and explicit information from Cigna is important. In addition, this claim was incorrectly denied three times. ASH was administering a different plan, than the health plan contracted. They are NOT handing any of these problems.Regards,
*************************Business response
07/24/2023
July 11, 2023
Dear Sir/Madam:
This is to advise you that ****** ******’s concern related to the amount paid to the provider has been resolved. The customer was advised the amount listed on the claim is correct per our contract with ******** ********* ****** (***). The provider’s contract is with *** and not with Cigna. Any dispute concerning the amount paid to the provider by *** will need to be between the provider and ***.
Sincerely,
Cigna's Office of Senior Leadership EscalationsCustomer response
07/24/2023
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
Complaint: ********
I am rejecting this response because: Again, when I spoke with Cigna Customer Service representatives I was told that an amount that was $20. more would be sent to my provider. That is, the allowable amount matches what is posted on the Cigna website EOB as payment to provider. In that conversation I was very clear and repeated my question would $93.--be sent to my provider and gave his name, name of practice, and address. I stated more than once-Is that correct? I was told, "yes". I asked for that to be confirmed and was told that a supervisor would call me within 24-48 hours which did not happen. When I spoke with a person from the Executive office I was told that the provider was ***. In the letter submitted to BBB by the Executive office the provider is now my physician. These facts matter when one is trying to get correct information. When speaking with the Executive office representative she was adamant about this definition of provider. In addition, members are not allowed to speak with ASH.
It does not seem to matter to Cigna that this claim was incorrectly denied by *** three times ( 2 appeals were denied) and they were using the wrong contract to administer benefits. The contract information comes from Cigna. So, ultimately, it is the responsibility of Cigna to insure that they are correctly administering benefits whether or not some of these benefits are contracted out to a third party administrator. It took someone from the Social Media department to get the truth. This is tangential, but my conversation with the Executive Office was less than stellar. After a member has had a series of negligent mistakes and complete disregard I was hoping for a more relational and respectful conversation.
Regards,
*************************Customer response
08/01/2023
8/1/2023
I received a letter from Cigna today re: this situation. Again, they are not addressing the problem(s). I was given inaccurate information from multiple people re: payment amount to my provider. The wrong amount is posted on Cigna.com. When i phoned customer service to clarify and confirm the amount and who it went to I was not given the correct information. I requested a supervisor contract me to double confirm. No one from Cigna called me. The definition that Cigna uses for a "provider" changes. In the letter I received today, dated July 26, 2023 my provider for this claim was referenced as a physical therapist. He is NOT a physical therapist, but a physician. Again, the truth is important to Cigna. This claim was incorrectly denied three times. *** was using the wrong contract to process claims. Even in the letter I received today they refer to this plan as a Cigna plan. It is not a Cigna plan/policy. They can rename it, but it is not a Cigna plan. it was not written by Cigna and the contract with my employer and Cigna is for Cigna to be the administrator of this already existing plan. This means that they administer the plan as written. The only that can be changed is the allowable amount. This can be "enhanced, but not decreased." None of this matters to Cigna. I spent over a year trying to get this claim processed directly. The billing department wrote two appeals that were denied incorrectly. I posted a complaint re: this claim on a website and someone from their (Cigna) social media department looked into it and confirmed that *** was using the wrong contract and that indeed I was correct about my contact language and this benefit. After speaking with more than 10 people to get the claim processed according to my health plan contract one person who had worked there approximately two months was able to get to the truth and find the exact page the reference the specific benefit. Cigna wasted so much time for so many people and continue to conduct business in this manner. Not to mention that members have not been able to access many of their benefits. There is not accountability, integrity. or oversight happening. And for what it is worth this health plan was for front line workers in the pandemic. In this letter received today it states, "we will not review this claim again." That is their choice, but Cigna did not process this claim correctly, without outside intervention, made over a year of mistakes, and have made no corrections.
Business response
08/17/2023
July 26, 2023
Dear Sir/Madam:
This is to advise you that ****** ******’s concern related to the processing of her claims has been resolved. The customer was sent a Final Determination Letter on 07/26/2023. She has been advised once again that the provider does not have a contract with Cigna. If the provider is disputing the amount paid to them on the claim, they will need to contact ******** ********* ****** as their contract is with them and they are the one’s that paid them. Cigna will not review this claim again.
Sincerely,
Cigna's Office of Senior Leadership EscalationsCustomer response
08/17/2023
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
Complaint: ********
I am rejecting this response because: As previously explained, Cigna contracts with *** to process a portion of their claims. *** follows the directives of Cigna. Cigna is responsible for providing the correct contract and information re: how to administer benefits. Cigna directs *** to not speak with members so it was not possible for me to work with them. As previously stated I had a three way conversation with a Cigna customer rep. and an *** employee. At the end of a very onerous conversation the fact that *** was using the wrong contract to administer benefits to members on this plan was discovered, but *** and Cigna were not willing to do anything about it to process my claim correctly. Prior to this I had been working with Cigna supervisor for months who just dropped the case which has been my ongoing experience with trying to get eligible claims covered correctly. I made a complaint on social media and someone for the social media department at Cigna contact me. They were able to locate the correct contract and find the benefit in question. Cigna and *** had been incorrectly handing this benefit for a years time. There is no reason that they could not have handled the claim according to the contracted agreement other than they just do not want to pay. To state that they have no responsibility for *** claims is not accurate nor ethical. I am very concerned that this is allowed or legal in this country. I have had multiple conversations with Cigna, the Cigna liaison to my insurance plan and my union and employer re: this and Cigna is responsible for claims processed by ***. My employer has terminated the contract with Cigna for a reason. This is unprecedented in the history of health insurance benefits with my employer.Business response
09/13/2023
September 13, 2023
Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404
Complainant: *************************
Dear Sir/Madam:
This is to advise ******************** complaint concerning her claims has been resolved. A final determination was mailed to the customer on 07/27/2023. The claims have processed correctly per the customers benefits and the providers contract with ******** ********* ****** (***). *** has paid 100% of the contracted rate to the provider. Cigna will not respond to this issue again.
Sincerely,
Cigna's Office of Senior Leadership Escalations
*****************************
Operations Lead Analyst, Service Delivery & CommunicationsCustomer response
09/13/2023
This is not resolved on my end. An eligible benefit was incorrectly denied more than three times. Many Cigna and *** employees were not able to correctly administer this claim. *** admitted that they were using the wrong contract to process and **** claims. It took someone from the social media department to actually try to look into what went wrong. She told me that I was correct and that my words matched the contract. She contacted *** and explained to *** that they need to use the correct contract and that this was a covered benefit and that there were no ground for denial. This was not an easy process for her. In other words, Cigna did not set up systems to process claims correctly with this employer's health benefit contract. Cigna and *** are both responsible for correctly administering benefits. In addition, the information on their website for members has unclear and incorrect information. I phoned to clarify terms and what the exact benefits were and how they had been covered. The information I was given was incorrect. This resulted in having the wrong amount identified as the edible benefit amount. Getting any correct information and benefits covered correctly requires hours into the double digits to get Cigna to do their job. It is by design and egregious. This may be resolved on their side as it is intentional so they do not have to pay. Simple as that.
Initial Complaint
06/07/2023
- Complaint Type:
- Billing Issues
- Status:
- Resolved
Cigna claims they were never contacted about a claim for annual lab work at quest. I was given the bill $433. Quest says they sent it 3 times. I put in a complaint against quest already. The lab work was completed on 8/22/22. My coverage with Cigna started on 8/1/22. I have called both sides 3 times to get this matter resolved. have a phone number for my 3rd party administrator **************. Today I received an EOB from Benefit Management. Their phone number is ************. I'm tired of getting the run around and spending lunch breaks on hold to resolve this matter.Business response
06/26/2023
Cigna is reviewing this matter and will be working directly with the complainant to resolve this inquiry.
We will notify your office of the outcome, upon completion.
Sincerely,
*********************
Senior Leadership EscalationsCustomer response
07/06/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Regards,
*****************************Initial Complaint
06/07/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
My daughter has had active insurance with Cigna since 4/1/23. On 5/5/23. She saw her healthcare provider for immunizations and preventative services. On 5/13 her claim was processed through CIGNA. However, CIGNA has her listed as not eligible and we received $1000 bill from her doctor. I have been trying to get this fixed for the last month as we should not owe anything since she had active coverage that I pay a lot for and its a preventative service. I have emailed and called. Each time I speak with customer service. I am assured that it will be taken care of and I will receive a call back which I never do. She now has upcoming shots and we are unable to get them unless I start paying for a bill that I should not owe on. At this point, unless somethings taken care of soon, I may need to contact a lawyer. As she will be unable to get her routine shots because of Cigna. This company has done nothing but give me the run around and I can not wait to change insurances.Business response
06/26/2023
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office, of the outcome, upon completion.
***************************
Senior Leadership EscalationsBusiness response
07/11/2023
June 28, 2023
Dear Sir/Madam:This is to advise you that ****** *******’s concern related to coverage for dependent was resolved prior to our investigation.
We have made attempts in reaching the complainant with no response.
Sincerely,
***** ************
Senior Manager, Executive CorrespondenceInitial Complaint
06/07/2023
- Complaint Type:
- Billing Issues
- Status:
- Resolved
Cigna required provider to obtain authorization from ******* for service. The correct authorization approval was obtained and valid for the date of service and included on the medical claim submitted to Cigna. Cigna denied the claim for no authorization. Provider contacted Cigna to verbally relay the authorization information, faxed copies of authorization approval letter to Cigna claim supervisor, confirmed she could view it and it was valid and even had a conference call with Cigna, ******* and Provider and ******* again advised auth approved and valid and retransmitted again. Claim was sent back and denied again for no auth. Mailed appeal via certified mail to Cigna including copies of authorization approval. Cigna refused to acknowledge appeal and advised its an ******* issue so appeal is not valid. This is a recurring issue with Cigna and they blame ******* but ******* has done everything they can to repeatedly transmit authorization approval to Cigna. All communication with Cigna has made it clear Cigna is fraudulently denying these claims. Last two calls Provider has made to Cigna have resulted in claims rep putting provider on hold for extended periods then hanging up. Provider wants someone with Cigna to respond so we can provide the necessary information and obtain resolution. Provider AR/Claims specialist ******* *** handling the matter ###-###-#### I can provide call reference# and everything else required. Just not posting it here due to HIPAABusiness response
06/27/2023
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry.Customer response
07/06/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
Cigna contacted me directly, I sent them a copy of the authorization they were disputing ever existed and they fixed the mistake they made and paid our claim in full. If I had not reported them to the BBB they would have continued to ignore the issue and gotten away with refusing to pay the claim. I wish I could publicly post the details of what occurred to shed light on their illegal interactions but due to HIPAA I cannot.
Regards,
*********************Initial Complaint
06/05/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
My father died 12/15/21 since the Cigna has continued to send explanation of benefits in his name to my home. I have called Cigna serval times to ask them to please stop sending mail to some who is deceased. I don’t think they understand that we are still grieving and my family does not need the constant reminders. I am not sure what else to do at this point to get Cigna to stop sending mail to my deceased father. The resolution is not another phone conversation with Cigna the resolution is to stop and let us grieve him in peace.Business response
06/20/2023
June 20, 2023
BBB
1411 K St. NW, 10th Floor
Washington, DC 20005-3404
Re: Customer: ******* *********
Tracking: **********
Dear Sir or Madam:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office, of the outcome, upon completion.
Sincerely,
***** ************
Senior Manager, Executive CorrespondenceCustomer response
06/29/2023
Complaint: ********
I am rejecting this response because: Cigna has continued to send my dead father mail now they are claiming he was the one to make a complaint on 6/20/23. It’s a bit impossible to have a deceased person since 2021 make a complaint in 2023. Please stop sending mail to a deceased person. The grievance department did not read the original complaint and they are not currently working with me or anyone in the family to resolve this issue as they claimed they would.
Regards,
******* *********Business response
08/31/2023
August 16, 2023
Dear Sir/Madam:
This is to advise you that **** *********’s concern related to his daughter’s complaint has been dismissed. An Authorization of Representation request was sent but a response was never received.
Sincerely,
***** ************
Senior Manager, Executive CorrespondenceCustomer response
08/31/2023
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
Complaint: ********
I am rejecting this response because:
The authorization they are requesting was addressed to my dead father. He is not able to sign forms or give authorization form the grave. Please leave us alone to grieve in peace do not send us anymore letter or request.
Regards,
******* *********Initial Complaint
06/02/2023
- Complaint Type:
- Billing Issues
- Status:
- Resolved
On 10.07.2022 while walking in local park (10 min drive from home) I lost conscience and fainted. My husband called 911.The Town of ******* ambulance arrived and drove me to local hospital. We got bill for $1695. CIGNA paid only $267.59. I called them on 12.20.2022 and they promised to negotiate the bill on my behalf or pay 90% of remaining sum and told that it would take 45 business days. On 01.20.2023 they paid another $123, told me to pay $644.49 and that case was resolved. However provider continued sending me bills for remaining $650.I called CIGNA on 02.17.2023, they promised to investigate and set deadline for 45 business days. On 06.01.2023 the case was still unresolved and status is unclear. Their representatives give confusing information, break deadlines and cannot make decision. I continue getting bills from provider. Health insurance company has to pay ambulance bills according Massachusetts General Law Chapter 176G, section 5. Claim#/ID *************/********* Account # EPAM ******** ***** *******Business response
06/20/2023
June 20, 2023
Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404
Complainant: *****************************
Tracking ID: **********
Dear **************:Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.
Sincerely,
**********************************
Senior Manager, Executive CorrespondenceCustomer response
07/07/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Regards,
*****************************Initial Complaint
06/01/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
We received a letter April 2023 from Cigna stating that coverage for our daughters *** ****** diabetes supplies was being denied. Since then I have been working with 6 different people to get it fixed, been on the phone for 10+ hours. The reason "Cigna" say she's being denied is "because she is not on insulin" and they need more "clinical notes" to show she is. She has been a Type 1 Diabetic for 13 years and has been on insulin since that time - she wasn't even 2 years old when diagnosed. The silly thing is, Cigna covered all these supplies for her 3 years ago when we were previously on Cigna. Our doctor has called Cigna, spent over an hour of his busy time to only be told to send in additional documents.Which he did and said this was the 2nd time he did so.And then a few days after that, I had to fight to have our health plan administrator get through to "Cigna" to check up on what our daughter's doctor sent, to only be told it will take 60 days (because they are so backlogged, they say) for them to go through the faxes her doctor sent containing the same info, "clinical notes", he's already sent before that shows she needs insulin and a ****** *** and the supplies.The people we call on the Cigna denial letter (we were told a month and a half into this process that we are dealing with a "3rd party company" through Cigna when we call) told us that this denial was done "electronically" so they can't tell us what was missing from her "clinical notes"; they also can't tell us if it's being processed or what we need to do to get it processed now that the doctor sent documents. We are then told we can't personally talk to the pharmacy review person. They say to do a Peer to Peer but that got us nowhere. We know this is a common occurrence with Cigna as we can read on BBB's reviews and find articles about claims being denied. There have been many times when this ****** *** alarm has alerted us to our daughters extreme low blood sugars.Business response
06/19/2023
June 19, 2023
Dear *** *****:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.
Sincerely,
***** ************
Senior Manager, Executive CorrespondenceInitial Complaint
06/01/2023
- Complaint Type:
- Billing Issues
- Status:
- Resolved
Hello-- my daughter is receiving orthodontist treatment. We have not received timely reimbursement from Cigna. Over the last 5 months I have been told differing information which has been incorrect. All chat transcripts are available for review.12/29/2022 Chat with *******-- advised there would be $1500 reimbursement. Nothing mentioned that the payment would be made in installments.1/24/2023 Chat with ******. He advised no claim had been received. (DOS was 12/27/2022. Submitted by the orthodontist 1/10/2023.1/26/2023 Chat with *******. She confirmed the claim actually was received. She noted payments would be made in installments over the course of treatment. A January payment of $576 was being made. Next payment would be in April for $305.34.4/5/2023 Chat with *****. She advised the check will be sent in April but she didn't have an exact date. She advised if payment was not sent Cigna would escalate the claim to get it corrected.5/9/2023 Chat with ******* (who was rude!). He advised payment would be made in May, not April.5/31/2023 Phone conversation with ****** (he advised it was a recorded line). He advised because two claims were received no payment had been made. When I expressed frustration over the lack of payment as well as the differing answers each time I spoke with someone he advised a manager/leader was unavailable and I would receive a callback. I did not.This is atrocious, unethical and misleading. This company should not be in business if they cannot be held accountable for payment of claims and information provided to policyholders.Business response
06/26/2023
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry.Customer response
07/06/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Regards,
*******************************
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Contact Information
Customer Complaints Summary
1,098 total complaints in the last 3 years.
363 complaints closed in the last 12 months.