ComplaintsforCigna

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Initial Complaint
10/09/2023
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
On March 2020 I received invisible aligners treatment for orthodontia from ***** ****** ****. I then submitted a claim to CIGNA dental for payment of their portion of the bill. The claim came back denied under the statement "Benefits are not provided for supplies or kits for orthodontic treatment to be rendered outside of the dental office (take home or mail order)." I appealed again, this time I also attached a copy of my Summary Plan Description proving coverage. in this document it states: - Under Covered Dental Expenses: “Provided by or under the direction of a Dentist or other appropriate provider as specifically described;” - Under Covered Dental Services: “Covered Dental Services delivered through teledentistry are covered to the same extent We cover services rendered through in-person contact including the same cost- share, frequency limitations or any applicable benefit maximums or lack thereof.” - Under Covered Orthodontic Treatment: “Comprehensive Orthodontic Treatment adult and child;” All these 3 items apply to my case as stated in the itemized receipt. Still, CIGNA completely ignored it and denied my claim again under the same pretext. I expect CIGNA to honor its policy as per the terms of our agreement.
Business response
10/30/2023
October 30, 2023

BBB
1411 K St. NW, 10th Floor
Washington, DC 20005-3404
Re: Customer: *****************************;
Tracking: **********

Dear Sir or Madam:

Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office, of the outcome, upon completion.
Sincerely,
**********************************
Senior Manager, Executive Correspondence
Customer response
11/06/2023
[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: ********

I am rejecting this response because:
CIGNA denied my claim again for the same pretextual reason. They are still unable to produce any document backing up their reason for denial.

Regards,

************************
Business response
11/30/2023
November 30, 2023
Dear Sir/Madam:
This is to advise you that ******** *******’s concern related to denied claims has been resolved. The complainant was notified and advised of the outcome. This is the
final review and resolution.
Sincerely,

Senior Manager, Executive Correspondence
Initial Complaint
10/03/2023
Complaint Type:
Customer Service Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I signed up with Cigna, policy # ********* effective 9/1/23. When I go to set up an account online, it says I don't exist. I have talked with customer service multiple times, who assures me my account is active. But to set up the online account I have to call the online department (************). They say they have no record of me and I have to contact customer service. No one is willing or able to resolve my issue. Everything is done through my online account which I have no access to.
Customer response
10/23/2023
Cigna has resolved the issue.
Initial Complaint
09/26/2023
Complaint Type:
Order Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I was prescribed a medication called ************ 5 mg. It is an intranasal spray used for the treatment of an acute migraine attack. Cigna requested a prior authorization, which is normal and my doctor completed it and it was sent over in March 2023. Cigna never notified me that this prior authorization was cancelled due to no response from my doctor's office for correction. The medical assistant confirmed she never received anything. This prior authorization was then cancelled three separate times without notifying me or the doctor's office. Finally, I called a fourth time and the supervisor said that they would push through the approval so that I could get this medication immediately and would call me back once the entire prescription had been approved. They also said I would never have to deal with this issue again as they would handle it. A month later, I went to refill the prescription and the same thing happened requesting a prior authorization. They accused my doctor's office again of not having done it correctly, so they called and did a phone authorization with both the medical assistant and me on the call, going back and forth between the two of us A month later, the exact same situation happened again. The supervisor informed me they would call me once it was approved and never did. Now I have called AGAIN and it is September 2023. I have been calling for SIX MONTHS to get this medication approved. If one month can be approved repeatedly, then it should be approved outright as I was promised. This is an egregious mishandling of my medical care and causing me undue stress and unnecessary hardship. I already suffer from chronic pain and multiple illnesses and Cigna should be held accountable for this. I have been told I would receive a call and have this approved about six times now and it is still not completed. All I want is my medication fully approved as promised.
Business response
10/30/2023
October 30, 2023

Better Business Bureau Serving Metro Washington DC & Eastern Pennsylvania
1411 K Street NW, 10th Floor
Washington, DC 20005
Attn: Dispute Resolution Department

Tracking ID: ********
Complainant: *************************

Dear Sir/Madam:

This is to advise you that ******************* concern related to not receiving her medication has been resolved. The medication requires Prior Authorization for coverage that was approved on September 26, 2023 and is valid until September 26, 2024.

Sincerely,

**********************************
Senior Manager, Executive Correspondence
Initial Complaint
09/19/2023
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have been in contact with this company since July for an issue I haven’t been able to resolve since. I’ve opened 11 chat conversations, called about 10 times and am consistently told the issue is being escalated and to allow an additional 7-10 business days for a call back. The initial contact where I reported being billed incorrectly was never filed or documented. I was given no explanation as to why the representative didn’t enter a dispute or provide a reference number. I’ve been billed $0 copays since 2020 and now since June, I have over $400 in claims Cigna is refusing to cover for the same service/same provider without any notice of changes to my coverage and benefits. I get different information every time I call, they’re harassing my provider seeking reimbursement for years worth of copays for an “error” they were responsible for. I have multiple coworkers with the same plan experiencing this issue and the amount of time and stress we’ve spent attempting to get resolution is very disappointing. Im at a loss for what to do and where to get help, this is a last resort as I would never typically file a formal complaint. I cannot afford the copays I’m being charged in error and I’m nowhere near satisfied with the way Cigna has handled their customers concerns.
Business response
10/04/2023
Tracking ID: **********
Complainant: ***********

Dear Sir/Madam:

Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office, of the outcome, upon completion.

Sincerely,
**********************************
Business response
11/01/2023
Tracking ID: **********
Dear Sir/Madam:
This is to advise you that ***** ***** concern related to claim reimbursement has been reviewed. Several outreach attempts have been made to the customer to discuss the outcome of our review, to date ***** ***** has not responded and therefore her case has been closed as resolved.
Sincerely,
***** ************
Senior Manager, Executive Correspondence
Business response
11/01/2023
Tracking ID: **********
Dear Sir/Madam:
This is to advise you that ***** ***** concern related to claim reimbursement has been reviewed. Several outreach attempts have been made to the customer to discuss the outcome of our review, to date ***** ***** has not responded and therefore her case has been closed as resolved.
Sincerely,
***** ************
Senior Manager, Executive Correspondence
Business response
11/13/2023
Tracking ID: **********
Complainant: ***** *****

Dear Sir/Madam:

This is to advise you that several outreach attempts have been made to ***** ***** to discuss the concern related to billing questions. To date, the customer has not returned our calls and therefore we have no choice but to close her case. Should the customer contact our office, we will be more than happy to assist with their concern.

Sincerely,
***** ************
Senior Manager, Executive Correspondence
Business response
11/13/2023
Tracking ID: **********
Complainant: ***** *****

Dear Sir/Madam:

This is to advise you that several outreach attempts have been made to ***** ***** to discuss the concern related to billing questions. To date, the customer has not returned our calls and therefore we have no choice but to close her case. Should the customer contact our office, we will be more than happy to assist with their concern.

Sincerely,
***** ************
Senior Manager, Executive Correspondence
Initial Complaint
08/30/2023
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have several, on-going issues with Cigna, for which I have spent dozens of hours trying to get resolved via Cigna and a separate health advocate, with no luck. One issue is I submitted a claim to be reimbursed for daycare. I submitted a receipt and the claim was denied. I was told it was because Cigna did not see the receipt that I attached, and that my claim would be reassessed. That was over a month ago and I still have not been paid. It is my own money that they won't give me access to. Another issue is that I received a bill for my daughter's hospital stay months after my out of pocket maximum was met. When I raised this issue with Cigna, I did not get a logical answer. I was told that my out of pocket maximum wasn't met, but that is impossible because Cigna had treated other bills as though my maximum was met and by their own calculation it was met previously. Another issue I've had with Cigna is that I have not been reimbursed for 2 prescriptions. I submitted receipts 3 separate times with the new/additional details Cigna told me were required at each denial, and finally the prescription was denied because the container that it came in was not covered by insurance, per Cigna. This is despite the fact that the container was on every submission; Cigna had me resubmit more detailed receipts for no reason, and I don't understand how a container couldn't be covered.
Business response
09/07/2023
September 7, 2023

Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404

Customer: ******* ****
Tracking ID: **********

Dear Sir or Madam:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Customer response
09/14/2023
[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: ********

I am rejecting this response because: it is a full week after Cigna said they will contact me and they have not contacted me.

Regards,

******* ****
Initial Complaint
08/29/2023
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Me and my daughter were on Cigna's health care plan at the time of her birth with service dates in September 2021. Cigna has covered all bills related to her birth; however, there is one outstanding bill that they continue to reject due to the "birthday rule." My husband was covered by ***** at the time, and ***** has confirmed over the phone with Cigna (two times) and via letter that my daughter would not have been automatically added to his plan at the time of her birth; therefore, the birthday rule would not apply. I have been working with representative ******** and after continuing to call multiple times a week, I do not receive any updates on the receipt of the letter and an update that the claim was submitted. This issue has been escalated to managers, and every representative I speak to confirms they will call me back with an update, but no one does. This has been the worst issue resolution with a company that I have ever seen. I let them know multiple times that I receive notifications that this is going to be sent to collections, but no one follows through with resolution or any updates.
Business response
08/30/2023
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office, of the outcome, upon completion.

***************************
Senior Leadership Escalation
Business response
09/22/2023
September 13, 2023
Dear Sir/Madam:
This is to advise you that ******** *******’s concern related to claim in September 2021 has been resolved. The customer was notified and advised of the outcome.
Sincerely,
***** ************
Senior Manager, Executive Correspondence
Initial Complaint
08/26/2023
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
on July 09, 2023, I took my daughter to her pediatrician as she was complaining her left ear was pain and "blurred" hearing in her left ear. The doctor checked and founded some cerumen in the left ear canal and we left and returned to recheck in 2 week. On July 28, 2023 we went back to the doctor office to recheck the ear since she had some fluid behind the TM at the time of last visit. I received the bill from the doctor in August and was told that the first office visit $247 (09 July 2023) was not covered by the insurance but the second office visit (28 July 2023) was covered. From the EOB, it said " ROUTINE HEARING EXAMS OR HEARING AIDS ARE NOT COVERED UNDER YOUR PLAN." under the office visit. It is NOT a routine exam and it is a procedure that doctor check and find out what's wrong with my daughter's left ear. It is so ridiculous that Cigna said they are not covered that. What's more, for the same ear problem, the first visit is not covered BUT the second visit is covered. It does not make sense at all. Also, from Visit Account Detail, there are only 2 billing code, the first is office visit $247 which they said not covered and the second one is "Removal Impacted Cerumen Irrigation Uni" which is $68, But from EOB, Under Surgery which is $68, it said "THE SUBMITTED PROCEDURE IS DISALLOWED BECAUSE IT IS INCIDENTAL TO A CODE BILLED ON THE SAME DATE OF SERVICE." Which code bill is identical to the $68 one?? I have no idea where the $58 in the EOB come from. I request Cigna to conduct a full and fair review of its decision for the bill on 09 July 2023 and I reserve my right to take my appeal to an independent third party for review.
Business response
09/08/2023
September 8, 2023

Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404

Customer: **************
Tracking ID: **********

Dear Sir or Madam:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.

Sincerely,

**********************************
Senior Manager, Executive Correspondence
Customer response
09/14/2023
[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.]

Better Business Bureau:

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

Regards,

**************
Initial Complaint
08/24/2023
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I keep receiving phone calls from Cigna Health from phone number ************. I continue to tell them they have the wrong number and to stop calling me. They called me on 8/18 and left a very detailed message about a patient that, i am not and have no knowledge of who this person is. They left full name, date of birth and the reason why they were calling. I called them to tell them they had the wrong number and they were rude. I received another call today 8/24 from the same number asking about a doctor office name. Again, i said remove my number since you keep calling me and it 's not correct. First and foremost, i do not even have Cigna Health Insurance, which is really concerning that they keep getting my information to call me about other patients. I want this resolved.
Business response
08/30/2023
August 30, 2023

Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404

Customer: ***************************
Tracking ID: **********

Dear Sir or Madam:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.

Sincerely,

**********************************
Senior Manager, Executive Correspondence
Business response
09/20/2023
September 20, 2023

Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404

Customer: ***************************
Complaint ID: ********

Dear **************:

Thank you for your patience as I, and other colleagues at The Cigna Group, reviewed *** ****** *******’s concerns regarding phone calls that she is receiving from Cigna.

We can confirm that this matter was referred to Cigna's Legal and Compliance Affairs Unit for review and investigation. These are their findings:

The Privacy Office reached out to *** ******* on September 7, 2023, and September 11, 2023. They were unable to reach her, and voicemail messages were left requesting that she return their call.

The Privacy Office subsequently reached out to *** ****** by email September 13, 2023, and she responded on September 15, 2023, asking that they no longer contact her.

The Privacy Office confirmed that *** ******* is listed as a Cigna member in our system.

We can confirm that there has been no documented communication or outreach to *** ******* by Cigna, aside from the Privacy Office’s calls to her regarding this complaint.

Cigna takes privacy protection seriously and has policies in place prohibiting leaving protected health information on voicemail. We are unable to substantiate her claim that Cigna made outreach to her by the phone telephone, and we cannot substantiate that Cigna left a voicemail containing patient information, as there is no record of this in our system.

*** *****, should you have additional questions or concerns, please call me at ###-###-####. I will be happy to assist you. Thank you again for sharing your concerns with the Office of Senior Leadership Escalations.

Sincerely,

*** *****
Operations Lead Analyst
Office of Senior Leadership Escalations
Business response
09/20/2023

Cigna's Statement on Robocalls:

It has come to Cigna's attention that individuals are receiving suspicious robocalls from an entity falsely identifying itself as Cigna. The purpose of these calls seems to be to collect personal information or to market insurance products and services.
These robocalls share the following characteristics:
Calls occur multiple times throughout the day.
Calls may come from different phone numbers.
Caller may request personal information under the false pretense that you are purchasing Cigna insurance coverage.
Automated recording may prompt you to "press 1 to speak to the operator or get your name taken off the list."

These calls are not coming from Cigna or any Cigna partners. Cigna and its partners will identify themselves as Cigna or a representative of Cigna and will comply with the Federal Trade Commissions' National Do Not Call Registry.
Protecting your privacy is very important to Cigna and Cigna partners. If you receive an unwanted or unauthorized robocalls that claims to represent Cigna, this is likely a malicious or fraudulent call, and we advise you to take the following action:
Please do not respond to the prompts or requests to share personal information, as this may cause additional calls.
Block the phone number(s) on your cell phone and/or through your carrier.
Report unauthorized/unwanted robocalls or other calls at one of the following federal agencies:

The ************************ at: **************************
The ********************************* at: ******************************************;
Initial Complaint
08/15/2023
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
This complaint is against Cigna overall and specifically the dental division. I had active insurance through my employer starting the beginning of the year. In March I departed from my company and went on Cobra until I find new insurance. In May I had a basic dental cleaning. Cigna has repeatedly denied my claim for coverage even though my Cobra bills were paid on time for each month. As a result I'm in jeopardy of this bill going to collections. Horrible experience where coverage is being denied for the most basic expense that is listed as part of the coverage. Don't select Cigna for your dental coverage, they wont pay.
Business response
08/28/2023
August 28, 2023

Better Business Bureau
1411 K ST NW, 10th Floor
Washington, DC 20005-3404

Customer: *******************
Tracking ID: **********

Dear Sir or Madam:
Cigna is reviewing this matter and will be working directly with the complainant to resolve the inquiry. We will notify your office of the outcome upon completion.

Sincerely,

**********************************
Senior Manager, Executive Correspondence
Business response
09/22/2023
September 11, 2023

Dear *** *****:
This is to advise you that **** *****’s concern regarding the delay in the processing her dental claim has been resolved. The customer was notified by letter on September 11, 2023.
Sincerely,
Office of Senior Leadership Escalations
Initial Complaint
08/11/2023
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have reached out to Cigna multiple times letting them know that the info that they have for me is incorrect as each time I go to the doctor or a provider, they tell me my deductible is not met and I satisfied the deductible in January, January 11th I had a procedure and I paid the deductible to ****** Surgery Center in San Tan Valley, AZ. They provided me with the information and I have given this to Cigna multiple times and since then I have seen doctors and had Xrays and MRI's and they are trying to charge me a deductible. I am tired of dealing with it and feel that now I have overpaid for everything. They tell me they will get back to me and NEVER do. I was told an audit was going to be done on my account as I spoke to someone earlier in the week and they said on Friday I would get a call from a Supervisor and have not. I did not expect it would happen as they tell me things all the time and it is never correct. Please help me with this as I am done waiting on hold, being transferred and then told they will take care of it and it has yet to be taken care of.
Business response
08/22/2023
Cigna is reviewing this matter and will be working directly with the complainant to resolve this inquiry.
We will notify your office of the outcome, upon completion.

Sincerely,
***** *****
Senior Leadership Escalations
Business response
09/01/2023
This is to advise you that Complaint ID # ******** regarding ******* ********’s the plan deductible accumulation concern has been resolved. The customer was notified on August 24, 2023 and advised of the outcome.

Thank you,

***** *****
Customer response
09/01/2023
[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: ********

I am rejecting this response because the information received is incorrect. I did pay deductible on January 11 to ****** Surgery Center in San Tan Valley and can prove it. I reached out to get the EOB.

Regards,

******* ********
Customer response
09/01/2023
I just spoke to ****** Surgery Center, South Valley and they are sending me over all the statements they have and they show that I did meet my deductible of $400 in January and said that it’s a situation between the collections department on their end and CIGNA that the claim has been paid it was submitted twice once in January and then again in May and it’s been going back-and-forth. In the meantime I’ve had to pay deductible amounts to other doctors and I’ve been trying to resolve this for months now and it is not my responsibility to keep following up on something that has nothing to do with me I paid my portion.
Customer response
09/01/2023
I just spoke to ****** Surgery Center, South Valley and they are sending me over all the statements they have and they show that I did meet my deductible of $400 in January and said that it’s a situation between the collections department on their end and CIGNA that the claim has been paid it was submitted twice once in January and then again in May and it’s been going back-and-forth. In the meantime I’ve had to pay deductible amounts to other doctors and I’ve been trying to resolve this for months now and it is not my responsibility to keep following up on something that has nothing to do with me I paid my portion.

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