CIGNA

------ Forwarded message ----------From: Revdex.com of Metro Washington DC Date: Mon, Jan 23, at 10:AMSubject: Fwd: ***_COmplaint ID# ***To:
*** *** ---------- Forwarded message ----------From: *** ***Date: Fri, Jan 20, at 12:PMSubject: Re: ***_COmplaint ID# ***To: [email protected] find attached a revised Authorization Release formI was contacted by Cigna and told needed to complete page of the document in its entiretyI mistakenly left two sections incompleteIn the attachment, I have completed page and attached it to the very end of the document as page Please let me know if you have problems accessing the document. I can be reached at ###-###-####

[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: ***
I am rejecting this response because it is all liesCIGNA ONLY refunded 2/and that is the only thing they are telling the truth aboutI had to file a complaint with my credit card to get my credit card to issue me the other credit and my dad filed FRAUD charges which CIGNA did not respond to when asked by his credit card company about the charges and he was refunded by his credit card companyAT NO TIME DID CIGNA OFFER A REFUND, RETURN MY MONEY, ETC EXCEPT FOR 2/THE CREDIT CARD COMPANIES DID!!!!!
Regards,
*** ***

Hello,Thank you for this informationI will be researching this issue and will follow up with the customer once a resolution has been met.Thank you,Nicole P***

Hello,
Thank you for this informationI will be in review of this issue and will respond directly to the customerThank you,
Nicole P***

[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,
*** ***

October 18, 2016Dear *** ***,We are writing to respond to your correspondence dated October 11, 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 ***
*** *** ** *** *** (***)and issued in Pennsylvania.*** *** indicated in her correspondence to you that she has been experiencing issues with her claim, including the time being taken to arrive at a claim decisionThank you for the opportunity to respond to *** ***’s inquiry, and provide an update on the status of her STD claim.Based on our initial review of the information on file, *** *** stopped working as of May 4, due to her conditionsIn order to be eligible for and entitled to benefits under *** *** *** ***.’s STD policy, *** *** was required to meet her policy’s provisions, including the definition of Disability and Pre-Existing Condition Limitation described as:Pre-Existing Condition Limitation The Insurance Company will not pay Disability Benefits for any period of Disability caused or contributed to by, or resulting from, a Pre-existing ConditionA "pre-existing condition" means any Injury or Sickness for which the Employee received medical advice or treatment within months before his or her most recent effective date of insurance.The Pre-existing Condition Limitation will apply to any added benefits or increases in benefitsThis limitation will not apply to a period of Disability that begins after an Employee is insured for at least months after his or her most recent effective date of insurance, or the effective date of any added or increased benefits.Definition of Disability/Disabled The Employee is considered Disabled if, solely because of Injury or Sickness, he or she is:

July 18, 2014Dear *** ***:This is in response to your letter dated July 1, regarding the above captioned matterRegrettably we have been unable to identify the area responsible for handling the account mentioned in your letter with the information provided by ***
***.The following items would be helpful in identifying the appropriate office handling this accountYou may send this information to the above address or fax it to us at ###-###-####.Complete Name of Group policyholder (Insured’s Employer)Group policy number - Complainant’s social security numberA copy of any correspondence from Cigna relating to this coveragePlease be assured that once we received the above information, we will respond to your inquiryShould you have any questions, please don’t hesitate to contact me.Sincerely,

Hello-
Thank you for frorwarding this customers complaintWe will review and folldirectly with the customer
Tanya H***
Cigna's Executive Office Of Complaints

Thank you for sharing this customer's complaint with CignaWe have followdirectly with the customer regarding this complaint
Tanya H***
Cigna
Executive Office of Complaints

Complaint: ***
I am rejecting this response because:Attached HIPPA Release FormRegards,
*** ***

Cigna has reviewed this complaint and resolution has been met with customerI have contacted and provided a verbal resolution to the memberThe member is satisfied

April 28, 2015Dear Sir or Madam:We are writing in response to your correspondence dated April 21, 2015, regarding *** ***’s claim for Short Term Disability (STD) benefits*** *** was covered under her employer provided, self- funded STD plan SHD ***, which was administered by ***
*** *** ** *** *** (***).*** *** has brought to our attention her concerns regarding the delay of her STD claim and benefitsWe appreciate the opportunity to address her concerns, and to provide the current status of her claim.Our office received *** ***’s claim on February 25, 2015, and after completing our initial eligibility and medical reviews, her claim was approved on March 24, Her benefits were released for the period of February 28, through March 21, STD benefits were extended on April 6, through April 7, 2015.For benefits to continue beyond April 7, 2015, our office needed to determine *** ***’s entitlement to continued benefits under the terms of her STD planUpdated medical information was requested, and was received in our office on April and April 17, *** ***’s medical records were reviewed on April 22, 2015, and it was determined that STD benefits were payable through April 27, On April 27, 2015, STD benefits were released for the period of April 8, through April 27, STD benefits will continue as long as the requirements of *** ***’s STD plan continue to be satisfied.We regret any stress caused to *** *** during the claim review processMoving forward, we will ensure that she is kept informed regarding any possible delaysWe would like to advise that although STD benefits are paid on a weekly basis, prior to those benefits being released, we must validate *** ***’s continued disability status.We appreciate the opportunity to be of service and hope that the information provided has been helpfulShould you have any further questions or concerns, please do not hesitate to contact our office.Sincerely,Bianca W***Consumer Advocacy Specialist

Complainant *** *** is not on the policy and we have not received a signed release to disclose personal information with *** I outreached to the complaintant yesterday and advised him resolution has been made and the letter will be sent to the policy holder at the time of service The complaintant seemed satisfied

Hello,Thank you for this information.I have resolved the issue and contacted the customer directly.Thank you,Nicole

Fraudulent companyMy mother was wokring as a doctor in Arizona for over years and when she gets sick and needs help, cigna gave her the run around and dont want to cover anythingleaving her homeless with no transportation, and nowhere for her belongingson the other hand in the CEO "David C***" of this company received a total compensation of $million, encompassing $million in direct salary, $million in non-equity incentives, $million in restricted stock awards, and $million in "other compensation" Hes a crookhim and his wife

February 2, Dear Sir or Madam:
We are writing in response to your correspondence dated January 25, 2016, referencing *** *** *** claim for Long Term Disability (LTD) benefits*** *** was covered under his employer's fully insured LTD group benefit policy ***This
policy was underwritten by *** *** *** ** *** *** (***) and sitused in the state of Massachusetts.*** *** raised concerns regarding his most recent LTD claim experience and claim decisionPlease allow us this opportunity to address his concerns, explain our decision, and provide an updated statusWith respect to *** ***'s employers LTD policy ***, in order for benefits to be payable, as of November 27, 2015, his medical records needed to support that his health conditions caused a functional impairment that would continuously prohibit him from performing the material duties of any occupationThe policy’s “Definition of Disability/Disabled" lays out these requirements and is defined on page of the enclosed policyWhile his LTD benefits were approved for a time, continued LTD benefits were not payable to *** *** beyond November 27, 2015, because he no longer met the policy’s definition of DisabilityThis determination was based on our ongoing medical review of the relatively stable findings received from his providersAfter a complete medical review of the available records on file, it was determined that *** ***'s condition would not render him Disabled beyond the date referenced above, according to the terms of his LTD policyAs a result, no further benefits were payable and his claim was closedOn September 3, 2015, a letter was sent to *** ***, which explained our decision, provided information that may be helpful to perfect his claim and further explained the appeal process.Subsequent to our decision, *** *** requested an administrative appeal review of his LTD claimAs part of our process, his entire file was referred to an independent peer reviewer for evaluationFor your reference, we have enclosed a copy of ***'s recent correspondence to *** ***, explaining that our prior decision on his claim was overturned on appealAfter reviewing updated medical information with an independent peer reviewer, it was agreed the information on file would support *** ***'s inability to perform any occupationAt this time, his claim has been forwarded to the Director of the Claims Department for reinstatementOn January 28, *** *** was advised of this outcome and processOnce this process is complete*** ***'s Claim Manager, Mark Wwill contact him and advise of the retroactive benefit amount that is being released to himIn the meantime, should *** *** require any additional information related to the claim decision or our process, he may also contact supervisor and Team Leader, Tom S*** directly at ###-###-#### ext, *** for further assistanceThank you for allowing us this opportunity to respond to your inquiry regarding *** ***'s LTD claimWe hope the information provided is helpfulDue to the volume, the Supporting documentation has been mailed to your attention under a separate coverShould you have questions or would like to discuss this matter, please do not hesitate to contact me directly at ###-###-####You may also contact CGI's Consumer Advocacy department regarding any group disability, life or accident concerns at:
Cigna Consumer Advocacy Attn: Meredith *L*** *** *** *** *** Phoenix, AZ *** Email: *** ** *** *** *** *** ***City Fax: ###-###-####
Sincerely,Rick P
Consumer Advocacy Specialist

Acknowledgement Letter along with Authorization for Disclosure of Protected Health Information form sent to customer on 12/07/2016.Charlene
V***Executive Office Advocacy Team

Cigna is reviewing this matter and will respond with additional information. We take patient confidentiality seriously.Protecting 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 her to give us permission to share our findings with the Revdex.com*** *** *** can grant this permission by signing the attached Authorization for Use and Disclosure form.Rae B***Executive Office Advocacy Team

Hello-
Thank you for forwarding this claim to CignaWe we review this complaint and folldirectly with the customerTanya H***
Cigna
Executive Office of Complaints

[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: ***
I am rejecting this response because:I received a letter from CignaThis letter fails to address the bills in disputeKaiser Permanente have produced detailed itemized bills indicating the services provided, and the amounts unpaid by Cigna (see attached) I have sent these bills to Cigna multiple times beforeThe bills are clear.
Cigna's letter contains generic explanation of benefitsThey do not address the billsThe figures under "amount billed" in Cigna's explanation of benefits do not match the bills in dispute, they correspond to a different claimCigna have failed to produce evidence that they have paid the items in the bill in full therefore ** legitimately maintain that Cigna have failed to pay
Furthermore, Cigna claim they simply ignored this case because the agent handling it had "retired" This is beyond irresponsible.
Please see the copy of the email from my employer's HR indicating that Cigna had agreed to a refundIt seems the company cannot maintain consistency within itselfbottom line is that this issue has caused great inconvenience as well as financial loss to me, solely as a result of Cigna;s mishandling of this case and lack of any effort to resolve it thereafter.
Prior email from my employers benefit :
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Hello ***,
Sorry this one was sitting with
me last week as there was one last item I was waiting forI followed up with
Cigna today the main issue is that the provider was behind and had not noted
some of the payments already made by CignaCigna has processed and correct the
claims with the providerYou will receive a refund in the amount of $
from Cigna, please allow up to two weeks for the check to arrive to your home
address
Please let us know if you have
any questions
Regards,
Benefits Team*** *** ***,
Milpitas, CA ***
F: + ###-###-####
***.com
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