ComplaintsforCigna

• Initial Complaint

  06/07/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  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 Escalations

  Business 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 Correspondence 

• Initial Complaint

  06/07/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  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 HIPAA

  Business 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

  More info

  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 Correspondence

  Customer 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 Correspondence 

  Customer 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

  More info

  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 Correspondence

  Customer 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

  More info

  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 Correspondence 
  
  

• Initial Complaint

  06/01/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  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,
  
  *******************************
  

• Initial Complaint

  05/30/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have called 6 TIMES and they still have not processed my claim. It is a simple $35 reimbursement for a rapid covid test taken at a pharmacy. Not rocket science. The claim under Zois ref# was **** then changed to ref #****. The last time I called the SUPERVISOR swore it was escalated and that someone would get back to me in a few days. And again NOTHING. This is pathetic. I submitted this claim for reimbursement in 2022. They sent letter needed code. I provided that code and called over and over and over again. Send me my $35 reimbursement already this is infuriating. ID#***********

  Business response

  06/08/2023

  June 08, 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 Correspondence

  Business response

  06/23/2023

  June 08, 2023

  Dear Sir/Madam:
  

  This is to advise you that ****** ********s concern related to a claim not processing has been resolved. The customer was notified and advised of the outcome.
  

  Sincerely,

  Senior Manager, Executive Correspondence

  Customer response

  07/13/2023

  THE COMPLAINT WAS PREVIOUSLY FILED HOWEVER BBB CLOSED IF BECAUSE CIGNA SAID IT WAS FIXED. Complaint ID: ******** It has been ANOTHER MONTH and I still haev not gotten my check. This is borderline fraud. I have a letter from ***** ************ Senior Manager that the problem with my claim not processing was fixed. ANOTHER MONTH AND I STILL DO NOT HAVE MY CHECK. I have wasted over 5 hours on this ridiculousness. Process my claim and now you should pay me for my excessive time. I am so MAD.

  Business response

  07/26/2023

  July 13, 2023

  Dear Sir/Madam:
  

  This is to advise you that ****** *******’s concern related to a claim that was not paid has been resolved. The claim previously applied to the deductible and has now been
  reprocessed to pay the customer. The customer was notified and advised of the outcome.
  

  Sincerely,

  Senior Manager, Executive Correspondence

• Initial Complaint

  05/23/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I submitted an out of network claim to Cigna for reimbursement - the first receipt from my Dr had an error on it and I followed the instructions of a Cigna representative who filed for that receipt to be canceled and after that I submitted a corrected claim as instructed. The visit on March 16, 2023 was $500 (paid in full at time of service) and this amount is on the invoice - in Cigna's system this receipt shows as $275 billed by the doctor, which is incorrect as it was clearly written $500 paid in full. I called at least 5 times over the last two months and spoke to many representatives. I got a phone message today from Cigna that the issue was resolved - which it is not - nothing has changed - the incorrect amount still shows online and I have not be reimbursed for the full amount. I would like this error to be corrected and to receive the reimbursement of the corrected amount.

  Business response

  06/07/2023

  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 Correspondence

  Customer response

  07/06/2023

  I was only notified that the business was working on it.  The case is not resolved - can you re-open it?
  Thank you,
  ********

  Business response

  10/30/2023

  Dear Sir/Madam:

  This is to advise you that on August 09, 2023, a letter was sent to ******** ***** of the review and resolution of the claim in question, along with a detailed list of the charges applied to her 2023 in and out of network deductible as of the date of the letter. 

  Sincerely,
  ***** ************
  Senior Manager, Executive Correspondence

• Initial Complaint

  05/17/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Cigna's delayed processing of medical claims. When my deductible is not met - the turnaround time is less than 8 days - as they don't have to reimburse the insured. However, I have noticed, now that I met my deductible and they have to reimburse me - they are delaying the processing of the claim. This has happened in the past. I have reached out to the company and they still haven't processed the claim. Additionally, they are not covering lab work - ordered by a physician in-network and performed at an in-network facility. This is disgraceful and is happening - i am sure - to millions of people who don't have the resources/time to complain.

  Business response

  05/17/2023

  May 17, 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 Correspondence

  Business response

  06/22/2023

  May 30, 2023  
  

  Dear Sir/Madam:  
  

  This is to advise you that ******* *****’s concern related to a claims reimbursement  has been resolved. The member was issued the reimbursement on 5/10/2023. The  customer was notified and advised of the outcome on 5/19/2023.  
  

  Sincerely,  
  Casie H***********  
  Senior Manager, Executive Correspondence 

• Initial Complaint

  05/16/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On 07-06-22 I went to my dentist because my rear anchor tooth of my 3 crown bridge had cracked. The tooth had to be extracted and the bridge had to be sectioned leaving me missing my back 2 teeth. My dentist placed 2 implants to replace the back tooth and the middle tooth that was bridged. Another bridge was not an option as my dentist told me you can"t put a bridge from a natural tooth to an implant. Cigna paid their part of the extraction and the sectioning but denied coverage for the implants after 3 1/2 months of phone calls on my part. My dentist is in network and implants are a covered procedure. Cigna said since I have 2 back teeth missing on the other side of my mouth that they are not going to cover the implants and that they think I should have gotten a partial denture instead and have made no further payment. My dentist and myself strongly disagree. I want to be able to chew food with my back teeth again and not worry about damaging my front teeth and this is why I have dental insurance. I don't think it is proper for cigna to dictate my dental care. I have filed an appeal and it was denied and my dentist has also filed I believe 2 appeals which were also denied. My dentist has requested a peer to peer meeting with a Cigna dentist and has been getting a run around on that. My maximum benefit is only $2000 a year. I would like Cigna to cover my implants with my remaining benefits. Per my EOB from Cigna "$646.60 has been applied towards your $2,000 in network individual maximum" so $1353.40 could be applied to pay for part of the implants. I have already paid the Dentist My part of the bill.

  Business response

  05/30/2023

  May 30, 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, Manager,Executive Correspondence

  Customer response

  06/24/2023

  [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: Cigna called me and continued to deny the claim based on that when the dentist sectioned the bridge I had 4 teeth missing on the bottom arch at that point in time and should have gotten a denture which the dentist said would not have worked because I only have back teeth on side of the mouth that the failed bridge is.  I want Cigna to pay something even if they have to make an exception in my case they could do it based on their untimely handling of my claim and stringing it along only to deny it.  It has now been almost a year and I still can't afford to finish my implants because of their denial.
  
  Regards,
  
  *********************
  

  Business response

  07/27/2023

  July 14, 2023

  Dear Sir/Madam:

  This is to advise you that ****** *** *****'s concern related to the denial of dental services has been resolved.  The final determination letter was mailed to the customer on July 14, 2023.  Cigna will not review this claim again.   

  Sincerely, 

  Cigna's Office of Senior Leadership Escalations 

  Customer response

  08/03/2023

  Last year when I was assigned an escalation person because of a bad review I left to a requested survey.  This person was also the first person to contact me with the news that my claim was being denied for the first time.  She was vey apologetic and said she had heard of instances similar to mine where Cigna would not pay for the implant for the stated reasons but would pay thier part of what a partial denture would have cost.  I would like Cigna to consider how my claims experience has been regarding this matter (It's been over a year) and do this for me as well. 
  If Cigna were willing to do this I would consider this whole matter including my BBB complaint successfully resolved.
  
  

  Customer response

  08/24/2023

  Cigna has stuck to original denial and has not offered any compromise although I was told by one of their escalation reps that this had happened in the past.   Therefore  I do not accept their decision.

  Business response

  08/29/2023

  August 10, 2023

  Dear Sir/Madam:

  This is to advise you that ****** *** *****'s concern related to the processing of his dental claims has been resolved.  The customer was notified verbally, on June 2, 2023, the claim has been denied correctly per his plan benefits.  The customer was sent a Final Determination Letter on 07/14/2023.  He has been advised a peer-to-peer reviewed was conducted, the claim has been appealed, and it has been reviewed twice by dental consultants and remains denied.  An alternate benefit is not an option.  The claim will not be reprocessed.

  Sincerely, 

  Cigna's Office of Senior Leadership Escalations 

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩