CIGNA

They approved my short term disability but keep making excuses about paying me. I have been trying for almost a month. I am unable to work because of cancer treatment and my bills are piling up.

Thank you for your response.In order for [redacted]'s visit to have counted for the 2014 incentive year, it would have had to have been completed no later than 10/24/2014. Therefore, the money is correctly applied to the 20o25 incentives.

Thank you for this information. I have reviewed the issue and a response was sent to the customer in writing on September 22, 2015. Thank you. Rae B[redacted]

Cigna is reviewing this matter and will respond with additional information.    We take patient confidentiality seriously Protecting our customers’ personal health information is critical. So 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. [redacted] can grant this permission by signing the attached Authorization for Use and Disclosure form.

Thank you for frorwarding this customers complaint. We will review and follow-up directly with the customer.  Tanya H[redacted]Cigna's Executive Office Of Complaints

Hello,
Thank you for this information.
I have been in contact with the customer and am working to research and resolve the issue.
Thank you,
Nicole

Hello-
Thank you for forwarding this complaint to Cigna. We will follow-up directly with the customer regarding this matter.
Thank you.
Tanya H[redacted]

Cigna sent me another release of information form last week,...

which I previously completed so I called them and I spoke with Tikia (sp) and she told me she would send me the requested information AGAIN because she said it looked like it hadn't been sent yet.   I then received the requested information about 3 days later so I think this nightmare is over and I appreciate all of your help! Sincerely, [redacted]

Hello,
 
I have outreached to this customer directly to go over this issue in full detail.
 
Thank you,
Kelly M[redacted]

May 12, 2014
Dear [redacted]:We are writing in response to your correspondence dated May 2, 2014, and in follow up to our e-mail exchanges regarding **. [redacted] and her claim for Short Term Disability (STD) benefits. As we indicated, **. [redacted] was covered under her...

employer provided self-funded group STD plan [redacted]. This plan was administered by [redacted] ([redacted]).**. [redacted] raised some concerns that her STD benefits have been improperly delayed and requested reimbursement. We would like to take this opportunity to address her concerns.With respect to **. [redacted]’s employer’s, [redacted], Inc., STD plan, in order for benefits to be payable, her condition(s), as documented by her medical findings, needed to support why she was unable to perform the material duties of her Regular Occupation. The policy’s “Definition of Disability/Disabled” lays out these requirements and is defined on page 3 of the enclosed plan.We initially received **. [redacted]’s STD claim on March 13, 2014, and after seeking and reviewing updated medical information from her treating provider it was determined the information on file would support her restrictions from work through April 7, 2014, which was the date her provider released her to return to work. As explained to **. [redacted], if she remained out of work beyond this date, updated medical records would need to be reviewed before any other benefits are payable.On April 21, 2014, updated medical records were received that supported **. [redacted] remaining out of work to her new release to return to work date of April 21, 2014. On April 22, 2014 after her medical review was complete, **. [redacted]’s STD claim was closed, and a final check was released for $1,597.94. This check represented benefits from April 7, 2014 through April 20, 2014, the date beforeshe was released to return to work. Our review of this information, also confirmed that on May 6, 2014, **. [redacted] successfully cashed this benefit check.We acknowledge **. [redacted] feels she is entitled to reimbursement for time spent waiting for our decision. However, her employer’s STD plan does not allow such a reimbursement request to be completed. If for some reason, **. [redacted] has accrued any medical expenses due to [redacted]’s request for ongoing supporting documentation, we will gladly submit repayment for these expenses once an invoice is provided confirming the amount. Should **. [redacted] have any specific questions regarding the reimbursement of these invoices, she can always contact her Claim Manager, [redacted], directly at [redacted] x[redacted] for further assistance.Thank you for allowing us this opportunity to respond to **. [redacted]’s concerns and we hope you find this information helpful. Due to the volume of the supporting documentation, it has been mailed to your attention under a separate cover. Should you have any further questions or require additional information, please do not hesitate to contact our office.Sincerely,

A confidential communication has been sent to the customer
in response to this issue.Thank you

Hello-
Cigna is in the process of reviewing this customer's complaint and will provide an update directly to the customer.
Thank you
Tanya H[redacted]

A written response was sent to the customer on 08-01-14 in regard to Revdex.com complaint # [redacted].

Received:Jun 29, 2015 12:53:08 PMExpires:Aug 28, 2015 12:53:08 PMFrom:CGI Consumer...

AdvocacyTo:[redacted]@myRevdex.com.orgSubject:Response to Revdex.com ID [redacted]Attachments:Revdex.com ID [redacted].pdfGood morning [redacted].  We were unable to upload our response on Friday to the site.  We understand the issue is that the response link was used previously to acknowledge receipt.  I was instructed by your office to send to your attention so that the issue may be closed correctly. Kindly confirm receipt.  If you have any questions, please do not hesitate to contact me. Thank you.Ruth H[redacted]

We are writing to respond to your correspondence dated April 21, 2016, regarding Joey [redacted]’s claim for Long Term Disability (LTD) benefits. Mr. [redacted] was covered under his employer provided, fully-insured LTD policy [redacted], which was underwritten by [redacted]) and issued in Georgia.Mr. [redacted] raised concerns regarding Cigna holding out doctor’s reports in our reviews. As we have previously explained directly to Mr. [redacted], during an external medical review records were accidentally left out of those submitted to an independent peer reviewer. Once this was brought to our attention, the records were then forwarded and we sought an addendum from this peer reviewer. We are confident that all of the records have now been considered and that a full and fair evaluation has been completed.Mr. [redacted] also indicated that we asked a specialist if we felt he was physically disabled, which is inaccurate. What Mr. [redacted] is referring to is a peer review report in which a peer reviewer indicated that he found evidence to support restrictions supporting his health condition dating forward from June 2015. We followed up with this reviewer and asked that they provide the earliest date these restrictions would have supported, at which point he confirmed only going forward from June 2015. To qualify for benefits, Mr. [redacted] needed to be deemed continuously disabled from October 29, 2014 forward. Since he was not, we upheld our previous decision to deny him further benefits.Should you have any questions or would like to discuss this matter further, please feel free to contact me directly at ###-###-####.Sincerely,Eric F[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 received a letter from Cigna. This letter fails to address the bills in dispute. Kaiser 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 before. The bills are clear. Cigna's letter contains generic explanation of benefits. They do not address the bills. The figures under "amount billed" in Cigna's explanation of benefits do not match the bills in dispute, they correspond to a different claim. Cigna 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 refund. It seems the company cannot maintain consistency within itself.bottom 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 : ----------------------------------------------------Hello [redacted],
Sorry this one was sitting with
me last week as there was one last item I was waiting for. I 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 Cigna. Cigna has processed and correct the
claims with the provider. You will receive a refund in the amount of $338.81
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
[redacted],
Milpitas, CA [redacted]
F: + ###-###-####[redacted].com
 ---------------------------------------------------------

I spoke with [redacted] this morning to advise her that her concerns have been resolved.

Thank you for this information.  I will be reaching out to the customer directly to have this issue addressed.
 
Thank you,
Kelly

Complaint: [redacted]
I am rejecting this response because:
------ Forwarded message ----------From: Revdex.com of Metro Washington DC<[email protected]>Date: Mon, Aug 3, 2015 at 10:53 AMSubject: Fwd: Complaint #[redacted] - CIGNA CorporationTo: [redacted] <[redacted]@myRevdex.com.org>
---------- Forwarded message ----------From: [redacted] <[redacted]@[redacted].net>Date: Fri, Jul 31, 2015 at 9:27 PMSubject: Re: Complaint #[redacted] - CIGNA CorporationTo: "[email protected]" <[email protected]>
Attn: [redacted] 
I have not contacted you to say whether I am satisfied with the the resolution of this complaint because there has been no resolution.  I have not heard from CIGNA other than a note saying they are investigating.  I would like to believe this is true and not simply a stall tactic.
[redacted] Sent from my [redacted]
Regards,
[redacted]

From: 
#ffffff; font-variant: normal; font-style: normal; font-family: arial; letter-spacing: normal; color: #222222; font-size: small;">Revdex.com of Metro Washington DC <[email protected]>Date: Mon, Feb 10, 2014 at 11:57 AMSubject: 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.
 
[redacted]