CIGNA

I will review request and have a supervisor contact customer with resolution Thank you, Kelly M***

Thank you for this information, It will be reviewed and outreach to the customer will take place Thank you, Kelly M***

Cigna is reviewing this matter and will respond with additional information We take patient confidentiality seriouslyProtecting our customers’ personal health information is criticalSo much so, that the Health Insurance Portability and Accountability Act (HIPAA) requires that we protect an individual’s private health information (PHI)Because this matter requires that we look into personal information, we need MrLefavour to give us permission to share our findings with the Revdex.comMr.Lefavour can grant this permission by signing the attached Authorization for Use and Disclosure form

Thank you for this informationA written response was mailed to the customer on August 3, Thank you, Nicole P [redacted]

[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.] Revdex.com: 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] ***

August 6, Dear Sir or Madam, This will acknowledge receipt of your correspondence dated August 5, 2015, regarding the above captioned matterPlease be assured that we will respond to your inquiry as soon as the necessary research is completed, but no later than the due date provided in your letterIf our research or response efforts are delayed for any reason, we will notify you in writing.Meanwhile, should you have any questions, please contact me directly at [redacted] Sincerely, Rick P Consumer Advocacy Specialist

Please be advised that a final response was sent to customer [redacted] on today 3/17/via mailPlease allow mail time for receipt Thank you

Our office has sent [redacted] a letter and confirmed with Cigna Individual Family Plans that her account is current and that all payments have been postedNo further notices will be sent Thank you

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted] I am rejecting this response because: IT took CIGNA days to reject this claim from a veteran of the united states army I have ten bad discs in the lumbar spine and in the cervical spine area.the policy was in force at the time of claims a check was sent the first time now the claim is rejected.A nurse makes the call at this company over my doctorsno wonder you have an F rating at the Revdex.com all you have to do is a google search of this company and see pages after pages of complaints.I would like to thank the Revdex.com for there time! [redacted]

Hello- Thank you for your inquiry. This is being reviewed and an outreach will be made to the customer upon completion. Thank you.

--- [redacted] *** [redacted] has been resolvedA resolution Email has been sent today to the customer with information pertaining to his concerns regarding the deductible & out of pocketPamela A D [redacted] ***

[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] Complaint: [redacted] I am rejecting this response because:I have still not been contacted by Cigna. There has been no resolution. This nightmare has now been going on for nearly two years. They need to pay the claim, like they repeatedly told me they would. Their business practices are atrocious! Regards, [redacted]

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

Complaint: [redacted] I am rejecting this response because:------- Forwarded message ----------From: Revdex.com of Metro Washington DC Date: Mon, Jul 13, at 9:AMSubject: Fwd: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint # [redacted] .To: [redacted] < [redacted] @myRevdex.com.org>---------- Forwarded message ----------From: [redacted] < [redacted] @***.net>Date: Sun, Jul 12, at 9:AMSubject: Re: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint # [redacted] .To: "[email protected]" The complaint is not resolved CIGNA has not responded.Sent from my [redacted] Regards, [redacted]

Thank you for forwarding this complaint to CignaCigna will review this complaint and will follow up with the customer
Charlene V***
Executive Office Advocacy Team

August 5, 2016Dear *** ***,We are writing to respond to your correspondence dated July 28, 2016, regarding *** ***’s claim for Short Term Disability (STD) benefits*** *** was covered under her employer provided, fully- insured STD policy VDT ***, which was underwritten by
Life Insurance Company of North America (LINA) and issued in Florida.*** *** raised concerns over her medical insurancePlease be advised we have forwarded these concerns to our Cigna Healthcare partners, who will address those concerns and assist in trying to resolve them for *** ***.*** *** also raised concerns regarding her STD claim denialAccording to our records, *** *** initially went out of work on February 7, In order to be approved for STD benefits, *** *** would need to be considered Disabled under the policyAccording to her Employer’s policy, Disability/Disabled is defined as follows:Definition of Disability/DisabledYou are considered Disabled if, solely because of a covered Injury or Sickness, you are: unable to perform all the material duties of your Regular Occupation, and unable to earn 80% or more of your Covered Earnings from working in your Regular Occupation.The Plan will require proof of earnings and continued Disability.Our claim manager requested and obtained medical records from *** ***’s medical providerThis information was reviewed with our Expert Resources Group, and the claim manager determined that the information provided was insufficient to support a functional loss that would have precluded *** *** from being able to perform her occupational duties past February 10, 2016.*** *** appealed this decision as of March 10, Her entire claim file, including the information sent in support of her appeal, was referred to our appeals team for them to perform an independent review of our previous decisionThe information on file was again reviewed with our Expert Resources Group, including a Nurse Case Manager and a Behavioral Health SpecialistAs of May 5, 2016, our appeals team determined that our previous determination should be upheldIt was again determined that there was insufficient information to support the restrictions and limitations placed by *** ***’s providers.We understand that *** *** continues to disagree with our decision, however in order for STD benefits to be approved beyond February 10, 2016, it was necessary that the information provided supported a functional loss that would preclude her from performing in her own occupationOur determination, which was upheld on appeal, is that the restrictions and limitations placed by her providers are not supported by the medical information providedIn our May 5, letter we provided *** *** with information on how she may file a second, voluntary appealWe have also outlined what legal actions are available, and the time limitations in placeShould she have any further questions regarding the decision or how to file a second appeal, she may feel free to contact her appeal specialist at ###-###-####.Should you have any questions or would like to discuss this matter further, please feel free to contact me directly at ###-###-####.Sincerely,Eric FCompliance Specialist CGI Consumer Advocacy

This will acknowledge receipt of your follow up correspondence addressed to Cigna Corporation regarding the above captioned matter,We have forwarded this matter to the appropriate area for research and response.Please be
assured that you will be contacted as soon as the area accountable has had an opportunity to conduct the necessary research in response to your inquiryWe will respond as soon as possible, but no later than business daysIf our research or response efforts are delayed for any reason, we will let you know.Meanwhile, should you have any questions, please contact us directly at ###-###-####.Sincerely,Ruth Bell H***

Thank you for forwarding this complaint to CignaCustomer was contacted on 3/16/by Cigna-HealthSpring Rx Customer Service to address their concerns.Charlene V***Executive Office Advocacy Team

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

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