CIGNA

We have been advised that **. [redacted] wants to withdraw her complaint. Her issues have been resolved. Revdex.com Case # [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 as Answered]
 Complaint: [redacted]
I am rejecting this response because: they did tell me to go through neurology to get developmental peds otherwise why would I take my daughter to the neurologist when she had no neurological symptoms (i.e. Sezuires) 
Regards,
[redacted]

Thank you for this request, a letter was sent to customer directly.
 
Thank you,
 
Kelly M[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 filed an appeal with this company lets wait and see how long it takes for them to screw this up. They are still telling lies about the things they did and didn't do.. They are claiming they sent me documents I never received. They are real good at trying to cover their lies but I know I didn't receive the things they say they sent and guess what else. I still haven't got any return calls from my case manager Matt. Wonder why it is he don't have the nerve to call me. he knows what he has done.
Regards,
[redacted]

Thank you for forwarding this complaint to Cigna. Cigna has reviewed this complaint and resolution has been met . I have outreached the member to provide resolution through telephone. At the time of contact, I was unable to reach the member but left my direct number for a call back. Erica...

M[redacted]Executive Office Advocacy Team

Hello,Thank you for this information.Written correspondence has been sent to the customer on 3/10/2016.Thank you,Nicole P[redacted]

I finally received the second check from Cigna so this matter is resolved. 
Regards,
[redacted]

February 2, 2016 Dear Sir or Madam:We are writing in response to your correspondence dated January 25, 2016, referencing [redacted] claim for Long Term Disability (LTD) benefits. [redacted] was covered under his employer's fully insured LTD group benefit policy [redacted]. This policy was underwritten by [redacted]) and sitused in the state of Massachusetts.[redacted] raised concerns regarding his most recent LTD claim experience and claim decision. Please allow us this opportunity to address his concerns, explain our decision, and provide an updated status.With respect to [redacted]'s employer's LTD policy [redacted], 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 occupation. The policy's "Definition of Disability/Disabled” lays out these requirements and is defined on page 2 of the enclosed policy.While his LTD benefits were approved for a time, continued LTD benefits were not payable to [redacted] beyond November 27, 2015, because he no longer met the policy’s definition of Disability. This determination was based on our ongoing medical review of the relatively stable findings received from his providers. After a complete medical review of the available records on file, it was determined that [redacted]'s condition would not render him Disabled beyond the date referenced above, according to the terms of his LTD policy. As a result, no further benefits were payable and his claim was closed. On September 3, 2015, a letter was sent to [redacted], which explained our decision, provided information that may be helpful to perfect his claim and further explained the appeal process.Subsequent to our decision, [redacted] requested an administrative appeal review of his LTD claim. As part of our process, his entire file was referred to an independent peer reviewer for evaluation.For your reference, we have enclosed a copy of LINA's recent correspondence to [redacted], explaining that our prior decision on his claim was overturned on appeal. After reviewing updated medical

I will review request and have a supervisor contact customer with resolution.
Thank you,
Kelly M[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:The recent message from the company states, "An electronic response was sent to the Revdex.com in regard to complaint # [redacted] for [redacted] [sic] [redacted] on 06-27-14."This information is not showing.
Regards,
[redacted]

Hello,This complaint has been received by Cigna's Executive Office Advocacy Team, and we will follow up with the customer for resolution. Thank You, Rafael P[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 as Answered]
 Complaint: [redacted]
I am rejecting this response because:
Why am I still not seeing a response about my medical and dental coverage? My dentist was only sent a portion of the bill and I also have two other bills that still need to be paid. I also was told I cannot appeal the decision if I have no new medical records, which I do not! The medical records I have state I cannot work or perform my regular duties and that should be all you need. I have never seen any of your doctors for my condition so how would they know anything about me? 
Regards,
[redacted]

We are writing in response to your April 11, 2016 inquiry regarding Mr. [redacted]'s Short Term Disability (STD) claim. Mr. [redacted] is covered under his employer’s STD Policy VDT [redacted], which was underwritten by Life Insurance Company of North America (LINA) and issued in the state of Florida.
In our April 6, 2016, response to your previous inquiry, it was noted that we had received a response from Mr. [redacted]'s treatment provider on April 1, 2016. That information was in the process of being reviewed when we sent our previous response. After review, it was determined that further records were necessary and were requested from Mr. [redacted]’s treatment provider.
While we understand that Mr. [redacted] feels that all needed records have been obtained, to ensure a fair and accurate review our claim manager felt it necessary to request additional documentation from his treatment provider. Another response from Mr. [redacted]’s treatment provider has been obtained, and as of April 12, 2016, is under review. Mr. [redacted] will be promptly notified of the outcome of our review, once a decision has been reached. If additional medical information is required from his providers, he will also be notified of this fact.
Finally, Mr. [redacted] brought up concerns that his claim manager had gone on vacation and his claim was left idle in her absence. While Mr. [redacted]'s claim manager was out of the office, other claim managers from ourclaims team continued the review of his claim. The claim manager's time out of the office has had no impact on the length of the review.
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],Compliance Specialist CGI Consumer Advocacy

Hello,
Thank you for this information.
I will be researching this issue and will follow up with the customer once a resolution has been met.
Thank you,
Nicole P[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 him 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. Alicia G[redacted] Executive Office Advocacy Team

I have been received a  letter from Rae B[redacted]  at Chattanooga, TN.  This letter was signed and Rae B[redacted] didn't leave their...

call back number.  I am not going to sign the Authorization for disclosure of  PHI Protected Health Information Act  or  HIPAA as listed in the letter that was mailed to me. They don't have the right to discuss any of my information with anyone but me.  I feel like them are trying to trick me. I have been playing phone tag with  Jessica L[redacted]. .I also receive two calls from the robot today ###-###-####. Can you please get your phone robots to stop calling me? Thank you,[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 as Answer Complaint: [redacted] for disclose
I am rejecting this response because:
Regards,
[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 as Answered]
 Complaint: [redacted]
I am rejecting this response because: Since I have filed this complaint I have received a letter and a phone call from 2 different companies that have been contracted by Cigna to "follow up" on ALL of my injures since November of 2015. These are over a year old and now they are trying to not cover them! I truly feel that this is them retaliating on me for me filing this complaint. Also they did not do anything but tell me my FSA card was back on which I was already aware of. They need to do something to fix this process and to make up for hassle and time I had to spend trying to figure this out for them! They also need to do some more training so that their employees know what they are doing. I would like my calls pulled and action to be taken!!
Regards,
[redacted]

Our resolution team has been in touch with the customer and worked through the concerns brought to our attention.  The customer was advised in a private conversation.

Received:Jul 21, 2017 03:08:03 PMHi [redacted], Complaint #[redacted] has been resolved. Verbal outreach on 7/17/2017 to customer with resolution. Resolution Letter sent to customer on 7/21/2017. Thanks,Charlene *. V[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]