CIGNA Corporation

Review: I have had so many issues with Cigna I'm not even sure how to categorize the nature of my complaint. I have been trying to purchase an individual health plan for myself and my baby since the beginning of August (I had my baby on August 1, 2014 and I quit my job on September 5, 2014 to be a stay at home mom. I knew I would need different health insurance and I wanted to be proactive about the process to make sure it would all be taken care of without problems. I want coverage as of September 1st with the qualifying event being the loss of my job). My Cigna sales agent is Degan Purvis at 1-800-886-7810 ext. 7617. I wanted the Cigna Copay Assure Gold plan and he told me we could get it processed after my baby was born and there would be no problem getting the September 1st effective date. I called back the first week of August 2014 to make sure it would go through without any issues and he told me to call after I quit my job. He quoted me $468.10 for the Copay Assure Gold plan for myself and my baby. When the time came to sign up, I called again and he told me he had actually found out that I would have to pay another $40 for pediatric dental for my baby if I signed up through Cigna but I could avoid it if I signed up through the Marketplace instead. Obviously I didn’t want to pay for pediatric dental for a newborn baby so I agreed and we did a 3-way call with the Marketplace to sign me up for the Cigna Marketplace plan. A few days later I called back and was told that the Marketplace could not give me an effective date of September 1st so I would have to pay for August even though I was still covered by my employer’s plan and didn’t need or want Cigna until September. So at this point, I had already been misled about the need for pediatric dental and the available effective dates of my plan. Degan said the solution would be to cancel the marketplace plan and sign up directly through Cigna after all because he had just found out that I actually wouldn’t have to get pediatric dental (shouldn’t he know more about the plans he is selling?) so we did another 3-way call with the Marketplace and they said they would cancel my application but it could take up to 30 days. Meanwhile, Degan filled out a paper application for me with Cigna and said it wouldn’t take long to process and that I would be getting a welcome packet in the mail soon. Ten days later, I called back because I still hadn’t seen anything and he told me that there was a problem processing my application (was anyone ever going to tell me this?) Over the next few weeks I had to call to get any update and I was told numerous times – by the Cigna agent – that the different departments at Cigna don’t communicate with each other and don’t get along and if I want to get anything done I’d basically have to figure it out myself. By now I had a five week old baby and no health insurance for her which is completely unacceptable. When I finally got ahold of someone in billing and enrollment (Matt was his name), he told me the policy went through and I was good to go and I just needed to make my first payment of $468.10. I told him during this call that I don’t trust Cigna with my money after all the delays there have been and he promised me that the effective date would be September 1st and everything would be taken care of as soon as I made the payment and gave me a confirmation number for the call so that it could be pulled up later if there were any problems (69664179). I made the payment on September 17th in good faith that we would soon have coverage. A few days later, Matt called me back and said that my plan was actually a Marketplace plan so my effective date would actually be August 1st (déjà vu?) He basically told me he couldn’t do anything for me and said that I would need to call the Marketplace. So he had taken my payment of $468.10 for an already canceled Marketplace plan without bothering to check to see if it was the right plan and then told me he couldn’t fix it. I was furious at this point and called Degan back to tell him that he needed to fix this mess. He told me he talked to Corporate and all the “big wigs” know about my situation now and “they” pushed my Cigna paper application through so everything would get figured out now. Lies on top of lies. Once again, nothing happened until I called back in and was told three days in a row that Cigna’s computer systems were down and they couldn’t even look up my Cigna application. When they could finally look it up on September 29th, a supervisor in billing and enrollment named Mya told me that they still hadn’t processed my application and couldn’t until I made the first payment. I told her I already made the first payment and she said that the payment I made on the Marketplace policy (which, again, was Cigna’s mistake) could not be applied to my Cigna policy so I would have to pay again. Oh, and by the way, the amount would be $507.10. I told her this was completely unacceptable and I would not be paying twice because Cigna messed up. I also told her my premiums are supposed to be $468.10 as I have ALWAYS been quoted, not $507.10. I told her the extra $39 was probably for pediatric dental and I’m not supposed to have to pay it. She said it’s not pediatric dental and the premiums must have increased because of my change in effective date from August 1st to September 1st. I explained that the effective date was always supposed to have been September 1st and Cigna just screwed it up and I refuse to pay more than what I have always been quoted. She said she couldn’t do anything to help me (what a surprise) and told me to call my sales agent about the change in premiums. She then said she would go ahead and apply my Marketplace payment to my Cigna policy (why did she tell me she couldn’t do that earlier?) and said she would call me within two days to collect the extra $39 and to verify that my application is finally processed. I told her I won’t be paying the extra $39 but I need the application processed because I have a two month old baby with colic and I can’t take her to the doctor because everyone I have dealt with at Cigna is incompetent. Today is now October 5th (six days later) and I still haven’t heard from Mya. I called and left voicemails for my sales agent Degan on September 29th and October 1st about the premium increase and he is mysteriously no longer returning my calls. My entire experience with Cigna has been horrible and I need health insurance for myself and my little baby. This is ridiculous. Oh, and they still have my money.Desired Settlement: I want verification that my Marketplace application has really been canceled and I want my Cigna application processed immediately with a September 1st effective date. I want my first month's premium (September) to be waived for all of the issues I've had to deal with and for the countless hours I've had to spend on the phone trying to fix the problems Cigna representatives created. I want my monthly premium be $468.10 and I want the payment I already made to be transferred to the correct Cigna policy (covering October). I want a phonecall from a Cigna supervisor who can tell me that this has all been completed and I also want it in writing emailed to me.

Business

Response:

Hello-Thank you for sending this complaint to Cigna. This matter will be reviewed and Cigna will follow-up directly with the customer. Thank you.Tanya H[redacted]

Consumer

Response:

Review: [redacted]

I am rejecting this response because:

Review: I received a bill from a lab company for service provided on 11/30/13 for $375.15. The claim was paid by Cigna and I owed nothing - no outstanding ballence. Then, for some completely unknown reason that Cigna seems unable or unwilling to disclose, the claim was denied AFTER it was paid, and Cigna took the funds back on 2/18/14. I didn't hear any of this until I received a bill for $375.15 on 3/1/2014 and called the lab company to find out why. I have spent over 4 hours on the phone with Cigna over several phone calls to resolve this, and we have even three way called the lab company. Cigna admits it is an error on their end, but months have passed and I keep getting this bill for $375.15. Each time I get the bill, I call Cigna and the the cycle repeats - with us three way calling this company. Cigna still has not paid them. I am still getting billed. And I am at my wits end and have no idea on how to resolve this.Desired Settlement: I want Cigna to pay the claim. If they are not paying the claim for some reason, then I want to know why they are not paying the claim. So far I have been told nothing other than "we need to receive the funds back before we can pay it" (which they did on 2/18/14). I also want to hear from Cigna why they made the mistake, and it would be really nice to be told that they are sorry for causing all of this. But I will simply settle for them paying the claim.

Business

Response:

Customer's request was completed and a response sent on 5/6/2014. Please expect to receive our response in 5-7 days.

Thank you.

Review: We purchased a family healthcare plan in December 2013 with Cigna and the Agent, [redacted] without our consent or signature on the Application enrolled us in a Cancer Insurance plan and without our authorization withdrew $170.50 from our Savings Account. we have sent several emails and placed several calls to resolve and requested a refund to no avail. His Supervisor, [redacted] will not call us back either..

Product_Or_Service: Healthcare Family Plan

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Refund

Refund our $170.50 plus interest since December 2013.

Business

Response:

Please note that this request is still in review. A response will sent directly to the customer upon completion.

Thank you.

Review: I purchased supplemental short term and long term insurance through my employer from Cigna Insurance. In April of 2013 I became very ill an am still unable to work due to my health. I have had multiple issues with Cigna regarding my insurance claim. After hiring a Lawyer I did receive payment for my short term disability, however I have not received any payment for my long term disability. I have supplied all the medical records, authorization forms, and paperwork as requested by Cigna. When calling to confirm that they have received the package I sent my case worker was unable to confirm. Cigna continually states that they do not have all that they need. I have requested multiple times that they supply me with exactly which records they are missing and can not get a straight answer. I am extremely upset that I paid for a service that is this unreliable and difficult to navigate. People who are ill are vulnerable and Cigna capitalizes on this. Their communication is horrible. Their customer service is horrible. The delay tactics they use are inexcusable and the stress it causes prolongs many health issues.Desired Settlement: DesiredSettlementID: Other (requires explanation)

1.Written documentation regarding my claim status.2.A written detailed account of all medical records they have received. Including the providers and date of visit.3.An explanation of the delay in processing my claim.4. An Apology5. Transfer of my case to an experienced claims manager and reviewal of my account by management.6. Expedition of this claim.

Business

Response:

April 28, 2014Dear [redacted]:We are writing in response to your correspondence dated April 23, 2014, regarding [redacted]’s claim for Long Term Disability (LTD) benefits. She was covered under her employer provided, fully insured LTD policy VDT [redacted], which was underwritten by [redacted]). The policy was issued in Minnesota.In her letter, [redacted] expressed concern regarding the handling of her LTD claim and requested a status update. Customer service is very important to us and we will continue to endeavor to provide high quality service. Due to strict privacy guidelines, we are unable to provide you with detailed information regarding [redacted]’s claim. However, we would like to clarify the policy terms that impacted her claim and address her concern.We received [redacted]’s claim for LTD benefits on January 22, 2014. In order to determine if benefits were payable under the terms and provisions of her LTD policy VDT [redacted], it was necessary for us to conduct an eligibility and medical review of her file. This included determining whether she satisfied her policy’s definition of Disability.On January 22 and February 6, 2014, we reached out to [redacted] without success. Because we were unable to reach her by phone, on February 6, 2014, we acknowledged the receipt of her claim in writing, and informed her of the policy’s requirements and what was needed to fully evaluate her claim. On February 7, 2014, [redacted] returned our phone call. During the phone conversation, we explained her policy provisions and informed her that to move forward with our review we needed updated medical information that we would request on her behalf.As part of the evaluation process, on February 17, 2014, we requested [redacted]’s medical information to determine how her condition was impacting her ability to function and perform the duties of her Regular Occupation as defined in her policy. On February 19, 2014, we notified [redacted] in writing of our request for medical information and listed all the physicians that were contacted. Because no information was received, on March 20, 2014, we notified [redacted] in writing of this delay. On March 26, 2014, we received the requested medical records and the information was reviewed by [redacted]’s medical specialists.The medical review noted that although she reported functional loss, there were no exam findings or validated functional deficits to correlate a restriction of no work or the level of physical impairment reported. In an effort to better understand [redacted]’s condition and how it was impacting her functionality, On April 11, 2014, we reached out to her treating physician by phone. Because the information obtained did not provide additional details regarding [redacted]’s condition, we were unable to substantiate her Disability. Based on this information and the review of her claim as whole, we concluded that [redacted] was not considered Disabled and on April 22, 2014, her claim was closed. A detailed letter explaining our decision was mailed to her attention on this same day.We acknowledge that [redacted] may disagree with our decision and she has the opportunity to request an administrative appeal review. Our April 22, 2014, decision letter explains how she can appeal and outlines information that may be helpful to perfect her claim. Additionally, and as requested in her letter, we will provide a copy of her entire claim file, including documentation regarding her claim status for review. In the meantime, should she have any questions or concerns regarding the appeal process she may contact our office directly at [redacted].We appreciate the opportunity to be of service and hope that the information provided is helpful to you. Should you have any further questions or concerns, please do not hesitate to contact our office.Sincerely,

Review: Cigna's claims processing has reached new lows. With respect to my claim number [redacted], I have received a series of claimed deficiencies in the claim. The deficiencies are false (I.e. claiming a form was illegible when it was not; claiming that I, a 32 year old attorney, was a member of a student health plan based on "records" that they refuse to disclose).

Fake claim denials is no surprise. What's unusual - and unacceptable - is (a) rather than listing all deficiencies in the first instance, Cigna has listed a new deficiency in each "round" of correspondence. We're on round 3 or 4 - I've lost count; (b) despite promising to review and respond to each resubmitted claim in a matter of days, responses are tasking weeks. It has been approximately 6 months since the claim was initially submitted. I have not yet been reimbursed.

Cigna's actions are so obviously designed to delay and hinder reimbursement of a facially legitimate claim that I'm speechless. I've been dealing with health insurers for over a decade, and I've never seen anything like this. I've also sent a similar complaint to the personnel at my workplace who select our insurance providers.

Finally - this isn't even a claim for a material amount of money! I believe I am entitled to less than $100 of reimbursement. It's the principle of unethical behavior that matters.Desired Settlement: I request immediate reimbursement and a letter from a responsible party at Cigna explaining how this has happened and why it will not happen again to my future claims.

Review: I made a call to precertify an out of network claim and was transfered between three different departments before being disconeccted. I have sent the documentation to the adress on my insurane card and have not been contacted or reimburesed.Desired Settlement: To be reimburesed and to recieve better service in future.

Business

Response:

We have been in contact with the customer in regard to Revdex.com# [redacted]. The customer is in the process of emailing information to Cigna so that we can bring his concerns to resolution.

Review: I recieved a check for 4,970.55. from Connecticut General Life insurance Co.thur The [redacted]. However I took it to my bank and found out its know good.And the **.state Police said to contact you.

Account_Number: acc# [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like something done about this, there has been others in my area that has had this problem.

Business

Response:

We have contacted Mr. Ford in regard to Revdex.com complaint # [redacted] has agreed to send us a copy of the documentation that he received and list in his complaint. We can not move forward until this documentation is received as [redacted] indicates that he is not a Cigna customer. Once we receive the information, we will research and follow up.

Business

Response:

Review: Cigna takes care of dependent care account for [redacted], my previous employer. I resigned from [redacted] (not terminated) on 2/4/2014. Normally, any claims made for dependant care can be submitted till march of next year (which is what cigna website is claiming). I tried to file claims on the website which is touted as the easiest way to file claims, but almost 2 months, the web link would not work for filing claims. Now I am being told that my claim cannot be processed because it has been over 90 days and CIGNA doesn't process dependent care claims after 90 days. Whose mistake is that if the website doesn't work. I tried multiple times over the period of 3 months. This is my money which is taken out from my salary. How can Cigna even think of taking this money from us? We don't owe Cigna anything. After multiple conversations with customer support, the issue is still resolved. The flex spending account has been reimbursed but not dependent care. I am looking around a 1000 dollar worth of my hard earned money. I need this claim processed immediately.Desired Settlement: Claim should be processed immediately. I need my money.

Business

Response:

Cigna has conducted an initial review of this Revdex.com

request and an update will be sent to the customer today, July 7, 2014. Once the review is completed, additional outreach will be made to the customer.

Review: Requested refund of premium and have been waiting for more than 60 days for a refund which was taken from me in less than 24 hours when it was paid.

On 4/30/14 I requested a refund of my premium that was pre paid for the month of May. I called to check on the status of this refund on 5/16/14, 12 days after refund request which was to take only 7-10 days and was told the check was sent to the wrong address. This was due to an internal error on Cigna's part. Cigna rep explained to me the situation and usured me that another refund with the right address would be sent and expidited by supervisor due to the inconvienence. Called back on5/30, 10 business later, to check on status of refund and found out from that rep that refund had not been processed yet. I asked to speak with supervisor was given every excuse in the book as to why I couldn't speak with one. I insisted I wanted to speak with a supervisor and when finally agreed I was kept on hold for 15 minutes just for the rep to come back and say I am still looking for one. It seems that either Cigna has multiple problems due to their neglegance or they are just lazy.I decided not to wait since I was at work at the time and was told once again my refund would be processed and expedited by upper management and would recieve refund within 10 business days. I called for the third time 6/18/14 because I still have not recieved any check and was told by Antonio (rep)that refund had just been processed Yesterday (6/17/14)and still had to wait an additional 10 business days before check will show. I asked to speak with supervisor once again to assertain a clear answer when I would recieve my refund and after minutes on hold [redacted] (sup)answered the phone and stated the same as Antonio. When asked for number to legal department [redacted] stated that there was none. Quote "So you are telling me that Cigna as a company has not one phone number to contact their legal department?" [redacted] stated no there is no number and gave me a P.O. Box number. Another showing of a major insurance company being greedy and not wanting to attend to their clients if you can call them clients.Desired Settlement: I want the refund of the funds I paid in for the insurance services I had requested but chose not to utilize. I paid this money in advance per Cigna's policy and I have been treated the same in return. In order to get money back it seems policy is thrown out the window.

Business

Response:

A written acknowledgement was sent to the customer on July 1, 2014. An outreach call was made to the customer today, July 7, 2014, to discuss the outcome of the review.

Review: Paid for the entire month of Jan 2014 but didn't get approved or notified of approval until 1/15/14

I applied for health insurance with Cigna Health online through [redacted]insurance.com on 12/13/13. 12/21/13 received an email stating that Cigna had received my application. 12/28/13 received an email stating cigna was reviewing my application and it could take 3-4 weeks to get the results. I checked online through [redacted].com several times over the next 10 days and kept seeing it was still being reviewed. On 1/14/14 a charge went through my bank for $1031.51 (My premium for Jan 2013. My issue is that I was never notified of active coverage prior to 1/15/14 so for the first 14 days of jan 2014 I paid for coverage I didn't know was approved nor did I have a policy number, cards or any indication of coverage. I called Cigna 4/15/14 regarding this and was told by a supervisor that since I put 1/1/14 as my requested date he couldn't help me. I then asked when Cigna approved my application he told me 1/13/14 and confirmed that no notification was or would have been sent prior that I should have known I could have gone to the dr. as the Obama health care act says no one denied. I am seeking credit for Jan 2014 as I was never made aware nor did Cigna provide any notification of coverage. [redacted] emails sent to me.....

Application Status

Current Status: Carrier Approved January 22, 2014 11:34PM

Congratulations, your application has been preliminarily approved for coverage.

View Status History

Status History Date

Carrier Approved 1/22/2014 11:34pm (PT)

Received by Carrier 12/21/2013 8:01am (PT)

Sent to Carrier 12/16/2013 8:10am (PT)

Application Received 12/16/2013 8:10am (PT)

Submitted -- eSignature Needed 12/16/2013 8:07am (PT)

Application Submitted 12/16/2013 8:07am (PT)

Application Started 12/16/2013 7:33am (PT)

Added to Shopping Cart 12/16/2013 7:33am (PT)

Next Step

You'll soon receive membership identification cards. The insurance company makes the final approval of your application and determines your coverage start date. Please DON�¿T cancel your current insurance until you have verified active coverage with your new insurance company.

* Related Documents

Your Cigna application has been approved([redacted])

From: [redacted] < customerservice@[redacted]insurance.com >

To: < [redacted] >

Sent: 01/23/2014 12:31 AM (PT)

You've Been Approved! [redacted],

Congratulations! Cigna has approved your health insurance application. Your coverage will be effective as of 01-01-2014. Thank you for giving us the chance to help you find a great new health insurance plan.

If you have an existing health insurance policy that your new Cigna plan is intended to replace, do not cancel it until you receive confirmation of your approval directly from Cigna.

As a result of the National Open Enrollment Period for health insurance, there may be a delay in receiving your policy packet and ID cards. You can expect more information from Cigna regarding your policy documentation.Desired Settlement: Credit/Refund equal to the first 14 days of January 2014

Business

Response:

Hello, THank you for this information. I have reached out to the customer to go over the options in regards to any premium reimbursement. The customer has my direct phone number for any questions. Thanks, [redacted]

Review: In 2012, I had gastric bypass surgery which resulted in hanging stomach tissue. the hanging stomach tissue later resulted in the treatment of skin irritation under the folds of my skin last Oct. I brought this up to my doctor, Dr. [redacted], during treatment of an unrelated issue. he prescribed ointment for the rashes and referred me to a plastic surgeon, Dr. [redacted]. I was denied by Cigna. The criteria set by Cigna stated that...

My stomach has to hang over my pubic area.

I had to have a stable weight for at least 18 months.

It had to be done to correct a medical issue that has been treated for last 3 months.

It is expected to correct a disfigurement.

The disfigurement is interfering with my quality of life.

Gastric bypass has to be done at least 18 months.

I have met all criteria listed above as I had gastric bypass Feb 7, 2012, which was over 2 years ago. My weight has been stable for the last 18 months. I have been treated for rashes since Oct 2013. My disfigurement is that my stomach hangs down past my pubic area and my stomach is a size 14 while the rest of my body is a size 8 (I have to alter all my clothes). The surgery is expected to fix this. It effects my quality of life as I sit a desk all day and cannot get up regularly to apply cream to the infected areas. I have had to quit wearing under garments as the elastic sometimes rubs the area raw. The moisture is uncontrollable during the summertime.

Every time I meet a criteria, they throw another stipulation in. The last appeal (I've had 2 already) was denied because I was not treated with antibiotics.

Each time I appeal, they say that they don't have the medical info to back up my claim but my doctor's are faxing it each time, including letters from my pcp and pictures from the plastic surgeon.Desired Settlement: I am asking for a panniculectomy. Not a full tummy tuck or liposuction for appearances. I have skin hanging from my upper arms, thighs, and breasts but not asking for any of that to be done. Just a panniculectomy to correct a severely hanging stomach and for the insurance company to quit finding other criteria for me to meet.

Business

Response:

I have sent coorespondence to the customer directly regarding the results.

Thanks,

Consumer

Response:

[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 Administratively Resolved]

Review: [redacted]

I am rejecting this response because:cigna has not agreed to cover any portion of the procedure even though I have met all criteria.

Regards,

Business

Response:

After External Review was completed, there was approval for this surgery. Please contact your Cigna or your Doctor to discuss the approval. Thanks, [redacted]

Consumer

Response:

[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.]I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. Regards, [redacted]

Review: Failure to assist in a payment error committed by them leaving me to foot the bill and after 2 yrs have don't nothing to pay the right provider.

I delivered a baby on 2/14/2011 when Cigna (Ins.ID# [redacted]) was billed they ended up sending the payment to the wrong provider. Instead of sending payment to **. [redacted] at [redacted] they sent the payment to a [redacted] in New Jersey. The Billing admin at **. [redacted] went back and forth with them for a year. They told her they had to wait for the wrong company to refund them before they can correct their mistake. All these reference numbers provided will provide proof of her contact and who she spoke with: 10/31/2012 [redacted] Ref#[redacted] stated she was going to speak with her supervisor [redacted] where nothing was done, 7/03/2012 [redacted] Ref#[redacted] Stated she was escalating to another supervisor again nothing was done, 5/17/2012 Supervisor [redacted] ref#[redacted] Said she will have this issue assigned to the finance dept to cut a check without waiting for the wrong provider to do a refund and she will call within a week. [redacted] never called and nothing was done. 2/29/2012 [redacted] ref#[redacted] Stated here that she sees the check where Cigna paid the wrong provider and a check will be reissued. 12/7/11 per cigna rep the payment was made to [redacted] supply company in New Jersey on 11/7/2011 check number is [redacted] for $2498.83 when it should have went to [redacted], MD At [redacted], MA [redacted] my account number with this doctor is [redacted].

[redacted] from **. [redacted]'s office reached out to me to try and help get this company to correct their payment error and send **. [redacted] the payment in which is due for his services. I first spoke with [redacted] on 1/28/2013 she told me she was sending a request for payment to the right provider and will call me in 7 days to confirm. I never go a call and payment was never made. on 3/4/2013 I spoke with [redacted] He had me on the phone in conference with the commercial medical supply (located in NJ) as he spoke to [redacted] in their accounting department stating they were issued a check in which they cashed that wasn't for their company, and he was requesting the refund from them. She responded rudely and demanded a faxed copy of the check in which Cigna sent them. [redacted] stated they were already sent the check copy twice to [redacted] in their billing dept. but he will gladly send it again with another refund request to [redacted], and she said rudely that she will look at it and if she finds this check she will issue the refund. [redacted] told me that he will call me in 2 days and see if he can have the check issued to the right provider which [redacted] without waiting for their payment discrepancy to be corrected. I heard nothing and nothing was done. I called back on 3/18/2013 and spoke with [redacted] who routed the call to her supervisor [redacted] who told me that this has gone on too long and she will have this expedited and paid within 24/48 hours without having to wait for the refund from the other company. She never called me back and the bill is still in arrears. I called back again on 06/27/2013 spoke to a rep that stated it was paid and had not further information. I have just recieved a demand for payment from [redacted]'s office stating this has gone on for far too long.Desired Settlement: This bill has gone unpaid because of their mistake in paying the wrong company. They haven't done anything aggressive to get this matter solved. I had the service done 2/14/2011 and they payed the wrong provider claiming they must wait for the refund from that company before they can pay. It is now 08/09/2013 and I am now being subjected to pick up the bill when this company should have paid it. I shouldn't have to pay for their mistake. I realize they have policies and procedures, but I th

Business

Response:

Good day,

I am in contact with the customer and have resolved the matter. The customer has my direct contact information in the event she has additional inquiries regarding this matter.

Thank you.

Consumer

Response:

[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.]

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.

Regards,

Review: For the past two years, Cigna conveniently decides that my home address and phone number are "incorrect" when ever they decide to raise my premiums. They are required to notify me of why they raise premiums - they NEVER have. instead I *occasionally* receive an email from them later stating that I need to provide Cigna with the correct mailing address and phone number because they need to speak with me - when this happens I then know that my premiums have been raised and they just don't want to talk to me about it.

I have tried to *correct* my address and phone number with Cigna at least 8 times, likely more. When I call and tell them to please correct my address and phone number I find out that they already have the correct address and phone number on file. I have proof of this in the form of an email correspondance with an agent, which I have taken a screenshot of (in case they decide to delete it) where the agent states my address and number on file are correct. This email directly follows another email from the company stating that they are unable to get in touch with me about a policy change because I have failed to provide them with my address and phone number.

On top of this, in TWO YEARS, Cigna has refused to send me an ID card, even though I pay my monthly premium and have requested one countless times. They have no explanation for this.

Cigna has also failed to update on upcoming changes to my policy due to Obamacare.

It is very worth stating that I changed banks during the course of my time with Cigna, and when I forgot to change over my bank account numbers and my bill was late my phone number and address on file with them worked PERFECTLY. They called to get the new info. Cigna HAS called me successfully.

Cigna lies because it means they don't have to fight with me on the phone about premiums. I also believe they want to make it more difficult for me to use their service by only allowing me a temporary Insurance card.

Again, I have proof from an agent that Cigna does indeed have my correct address and phone number on file - and I have proof in other emails that Cigna conveniently loses these when they decide to adjust my premiums. I will be more than happy to provide these.Desired Settlement: Since Cigna has lied about attempts to contact me and has raised my premiums without explanation, I want a refund of those raised premiums, plus a return to the old price I paid when I first signed up with Cigna.

Refund and billing adjustment.

Consumer

Response:

From: Revdex.com of Metro Washington DC <[email protected]>

Date: Mon, Feb 10, 2014 at 11:57 AM

Subject: Fwd: Checking on complaint [redacted]

To: [redacted] <[redacted]>

---------- Forwarded message ----------

From: [redacted] <[redacted]>

Date: Sat, Feb 8, 2014 at 6:42 PM

Subject: Checking on complaint [redacted]

To: [email protected]

Hi there,

I was told my complaint was transferred to your office. I have new information on my complaint that I wanted to pass along.

I have spoken with Cigna twice since I reported my complaint to you. Both times they have failed to be helpful. On Thursday they called and left me a message telling me to call them back - I called the exact number they told me to call at 12:35pm Pacific time. The woman I got on the phone knew NOTHING of my issues with the ID card and raised premium complaints. She said there was no record, she claimed there wasn't even any record of the call made to me a few minutes before. She said she didn't know why Cigna even called me. ??????

I of course explained the situation, her response was that it was the post office's fault that I had not received ID cards or notices and explanations of why my premiums have been raised without explanation for over two years. That Cigna had done everything in their power over these last few years and that the post office was to blame. This is a complete lie. I received an email from Cigna where an agent told me that they had failed to enter my apartment number for the past two years. I have attached it. I cannot express to you how many times I have called Cigna and emailed with requests for them to make sure my address was correct. Every time they say they will fix the problem. They did not.

The woman would not discuss a refund for my raised premiums, repeating only that it was the post office's fault I was not informed. Again, I have proof it is Cigna's fault.

When will there be a response from Cigna about my complaints? Do you recommend I report Cigna to another agency as well?

Thanks so much.

Review: My young disabled daughter has dual insurance coverage. Cigna is her primary and [redacted] is her secondary. Cigna has started using a third party, [redacted], to pay for their responsible portion of my daughter's bills. We have never dealt with [redacted] and they are not authorized to pay for our responsible portion of her bills. Starting earlier this year, we have started receiving invoices for [redacted] for wheelchair modifications. They are asking for us to repay them for the portion of the bills which are not covered by Cigna. However, I have confirmed with the vendor [redacted] (formerly [redacted]) that our responsible portion has already been paid by [redacted] as it should be. [redacted] did not make those payments to [redacted] on our behalf. In spite of me making several attempt to correct the issue over the phone, they have recently turned us over to a collection agency ([redacted]). We have never established any account with [redacted]. They have never provided any services to us. The charges they are trying to be reimbursed for were never paid by them or owed by us. [redacted] is a client of Cigna and do not have any connection to us or to [redacted].Desired Settlement: Cigna needs to send a letter to us indicating that the following will be taken care of immediately and should consider terminating the use of [redacted] needs to cancel the Debt Collection because it is fraudulent. [redacted] needs to send a written letter stating that they have corrected their errors and will no longer attempt to collect money which is not due to them. [redacted] needs to send a written letter stating that they understand that they are not authorized to make purchases for services or goods on our behalf. [redacted] needs to provide better training to their employees and make them aware that they should not make statements that "it shouldn't be a problem any more because they put a note on the file that there is dual coverage".

Business

Response:

Hello, Thank you for this inquiry. I have reached out to the customer to obtain further information, and will continue to do so until completion. Thank you, Kelly

Review: On 7/31/2014 my wife, [redacted], went to have a procedure performed only after Cigna guaranteed 100% coverage. Cigna refusing to honor.

Policy Number 000234359

Ref [redacted]

In May of 2014 my wife [redacted] had a family planning surgery performed that was covered by Cigna at 100% under family planning as part of my insurance plan. 3 months later, on the 9th day on her menstrual cycle she was scheduled for an FDA required follow up screening to ensure the procedure was successful. Hours before the follow procedure on 7/31/2014 we were told there would be a $500 deductible charge. We then canceled the procedure. I called cigna several times that day and eventually spoke to a gentleman and his supervisor (which is noted in their very own notes) that the procedure would be covered at 100% and if there were any issues to call cigna back and they would handle and the whole issue revolved around the hospital not having the proper codes for family planning. After the cigna employee and supervisor told us this with the hospital on the phone, we called back and rescheduled the appointment only after being given the go ahead by Cigna. A month later we receive several bills and as instructed and ended up speaking with Charlene who noted herself that the call log notes did state "cigna would cover at 100%." Charlene filed an appeal on my behalf which cigna then denied.

There has been no payment made yet and there will not be on our end. This charge would have NEVER happened had the Cigna employee and supervisor not have told us to go ahead and have the procedure done and the procedure would be covered 100%. I have spent hours on the phone with the doctor, provider, insurance, and hospital and the Insurance company who promised me they would take care of it is not standing by their words that are included in their very own call logs (Ref: [redacted])

I have called cigna back after the denied appeal and to move forward it requires more work on my behalf and Charlene passes the blame to the provider and does not stand by Cigna's promise. I have also spoken to another individual on 10/6/14 at 7:18 PM who started to tell me that the notes I spoke of did not exist. Only after having to nicely threaten legal action did he somehow find the notes.

This is a complete unethical and horrible business practice. The appeal that Cigna denies, Cigna never mentions anything about the promise they made but puts the blame on myself and the doctors. However, I state again. This bill is never created and the procedure is never performed had Cigna not given the go ahead with the 100% coverage that they have noted in their very own call log. Cigna refuses to take responsibility.Desired Settlement: The demand is for Cigna to stand by their promise. If this is not done an attorney will be retained. This report is also being filed with TN Consumer Affairs and TN Commerce and Insurance.

Business

Response:

Hello,Thank you for this information. I will be in review of the issue and will respond to customer once review is complete.Thank you,Nicole P[redacted]

Review: I have diabetes, severe depression, and anxiety. My eyesight is diminishing, I have neuropathy in my legs. I've had a recent suicide attempt. I lost my job. I made a short term disability claim in February. I was contacted for additional information. I called but could not reach the claim representative, so I left a voicemail message. After hearing nothing for over four weeks, I contacted Cigna and found out the claims representative had been changed. She wasn't in, so I left a voicemail message. My Feb. 20 claim was denied for lack of information on May 16. I appealed. My case was assigned to someone else. I received a letter saying a decision would be made in 15 days. More than 15 days later, I received a letter saying they needed 45 more days to make a decision. Finally, I received a letter dated Aug. 19 that upheld the denial of my claim. It did not appear additional information had been gathered. Originally, information was supplied by a nurse practitioner when my doctor left the practice. In my appeal I provided the name of my new doctor and urged them to request my entire diabetic medical history from 2000 to the present in order to show the progression of the disease. Also, after a suicide attempt, I gave them the name of my psychiatrist who I began seeing in addition to my therapist in May. I had saved three months of my salary, so I managed to get through the summer. Now,after paying premiums for nearly 17 years of full time teaching without my disability insurance, I am losing my house and car. I can't pay utilities so I am moving to sponge off of a family member. I have no health insurance, so my psych meds are gone. I want this on record because if I do not live through this horrific time, I want others to beware.

Product_Or_Service: Short & long term disability insurance

Order_Number: [redacted] Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

I want them to request my complete medical history from my doctor and I want my claim approved. I cannot imagine that diabetes which has gotten worse over the last 14 years does not qualify as a disability.

Business

Response:

Hello,Thank you for notifying CIgna of this complaint. We will be following up with the customer directly.Thank you,Nicole P[redacted]

Review: In short, Cigna has not paid me $885.00, which was first requested on January 4, 2013. It is now March 11, 2013.

I have a Dependent Care Reimbursement Account (DCRA) with Cigna. Cigna policy states they will provide a reimbursement for any claim, which is not rejected, within 15 business days. I have called over 12 times and have not found a resolution for this issue. The issue started with Cigna processing the claim in the wrong period (2012). Since there was no money remaining in the account from 2012 Cigna rejected the claim. In addition they are well outside the 15 business day commitment.Desired Settlement: I want the CEO of Cigna to call me and appologize for their terrible service. I would be imbarrassed if I ran a company that operated so poorly.

Business

Response:

Our final response was sent to [redacted] today (3/21). Customer was advised of the outcome of our research, we do not have permission to release the outcome of our research without a signed release of information from the customer.

Thanks.

Review: I UNDERWENT SURGERY FOR A MEDICAL CONDITION DOCUMENTED BY MY DOCTOR. CIGNA APPROVED THE SURGERY, FOLLOWING THE SURGERY I BECAME ILL AND WAS TAKEN TO THE ER DUE TO DEHYDRATION, I WAS TREATED AT THE ER. CIGNA HAS FAILED TO PROPERLY AND TIMELY PROCESS AND PAY ALL MY CLAIMS FOR BOTH DATES OF SERVICE. THEY WILL NOT RETURN MY CALLS NOR HAVE RESPONDED TO THE APPEAL I REQUESTED. I HAVE MET MY DEDUCTIBLES FOR THE YEAR AND SHOULD ONLY BE RESPONSIBLE FOR THE CO-PAYMENTS FROM THIS POINT FORWARD YET CIGNA REFUSES TO PAY THE HEALTH PROVIDERS. I HAVE MADE NUMEROUS ATTEMPTS TO REACH CIGNA AND GET THIS RESOLVED, I CONTINUE TO RECEIVE BILLS FROM THE HOSPITAL AND OTHER HOSPITAL RELATED PERSONNEL. ITS BEEN 2 MONTHS NOW AND I WANT TO GET THIS RESOLVED AS SOON AS POSSIBLE WITHOUT HAVING TO INVOLVE ANY LEGAL WORK WHICH I CAN NOT AFFORD, BUT ITS THE ONLY RECOURSE I HAVE NOW SINCE I DO NOT HAVE THE OVER $20,000 TO PAY THE OUTSTANDING MEDICAL BILLS.Desired Settlement: DesiredSettlementID: Other (requires explanation)

I WOULD LIKE CIGNA TO CONTACT ME TO DISCUSS THIS MATTER AND GET IT RESOLVED AND I WANT THESE MEDICAL BILLS PROCESSED IMMEDIATELY.

Business

Response:

We tried to contact the customer by telephone on 12-12-13, was given her celll phone number. Tried to contact customer 12-13-13, no answer, left message to contact Cigna. We are in the process of bringing this complaint to resolution. ([redacted])

Review: I am an in-network mental healthcare provider for Cigna. We have a contracted agreement that I will be paid $47.82 per session for providing psychotherapy to Cigna's subscribers. Regarding their subscriber, ID# [redacted]: Cigna paid me zero for two sessions: 1/15/ and 1/22/13 and claim that they sent me a check and it was cashed. I did not receive the check. They paid me $26.00 instead of $47.82 for following sessions in 2013: 5/16, 5/22, 5/30, 6/6, 6/20, 6/27, 7/11, 7/18, and 8/15. I have contacted and spoke to several Cigna employees to collect my payment and have yet to receive it.Desired Settlement: Desired Settlement: Other (requires explanation)

I would like to receive agreed upon payment for my services as a psychotherapist for Cigna Healthcare. That total owed me is: $292.02

Business

Response:

Health Care Provider [redacted] was contacted and conscented to continue working with her Cigna Provider Representative with regard to any outstanding claims and contract issue. Closing issue. Thank you.

Review: My son and his father are covered by Cigna Health Insurance through the [redacted] Union. We were advised by the [redacted]s Hospital of [redacted]) that our son had a medical condition in which he needed a helmet. [redacted] gave us a written letter stating this was a medically necessary item. As any parent would do, we made plans to get this device. When I called Cigna in April of 2013 with the code, the gentleman I spoke with told me this device would be covered. After going to get the device and the office trying to bill for it, we were informed it would not be covered. From this point forward Cigna failed to provide good customer service. We went through the appeals process with the employer, [redacted] Union and Cigna. There were many instances I would make phones calls, leave voicemails and not get a call back. There were times when Cigna representatives and Union representatives couldn't agree on what the appeals process was and how to go about it.

I have spoken with many different people at Cigna. After weeks of getting nowhere with an individual I request their supervisor. Then I have someone call me who is "higher up" and they promise to help me and resolve the issue. I am now in correspondence with the third person who was "higher up" and could help me. This has been going on since April of 2013 and it is seven months later. I have spent hours on the phone, on hold, writing emails, writing letters and I believe it is unfair. We pay a premium for the health insurance and not only do we deserve decent coverage but we deserve good customer service.

I told a Cigna employee by the name of [redacted] Stone that I had planned to write to the President of Cigna. In this letter I wanted to include the dates I called in for customer service, who I spoke with and the notes from the call. [redacted] advised me there was a form I had to complete and send back in that would get me the information I was looking for. I completed the document and sent it in. I received a letter back saying my request was denied. I do not understand why records of my phone calls cannot be given to me. When you call any big company nowadays - they tell you they are recording your conversation. We know full well they have recordings of these conversations and written notes in their database. I am not asking for the recordings at this point, simply the notes. I am not asking for notes on someone else's calls. These are my calls.

I refuse to be taken advantage of. After filing the complaint with the Revdex.com, I plan to send a letter to the president of Cigna and the Insurance Commissioner for the State of PA.Desired Settlement: My desired outcome is that Cigna reimburses me for the expense of the device we purchased for our son. I feel this is appropriate because the first time I called regarding this matter I was told by a Cigna Customer Service representative this was covered. I also feel it is appropriate because we pay over $1000 a month in health insurance premiums and the expense of the helmet is $1,500.

Ideally, I would like Cigna to reimburse me for my time calling, waiting on hold, writing emails and letters. A customer should not have to put in this much time and effort to receive good customer service. I should not have file a complaint. I should get good customer service because I pay for it. If all was fair in this world I would bill them for my time.

Lastly, I would like a formal explanation as to why I was treated so poorly and how this situation will be rectified in the future. An apology would be much appreciated.

Business

Response:

Thank you for bringing this to Cigna's attention. We have been actively working with the customer through alternate channels to resolve this matter. Once resolved, I will provide the customer's mother with full resolution detail.

Thank you,