CIGNA

Thank you for forwarding this rejection to CignaA letter detailing the plan benefits and the customer’s out-of-pocket accumulation was mailed to the customer on 10/25/2016. After review, it has been determined that the out-of-pocket has not been over applied.The Executive Office of Cigna has sent a resolution letter to the customer on 10/27/2016.Charlene V***Executive Office Advocacy Team

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 her to give us permission to share our findings with the Revdex.comLaura Ettleson can grant this permission by signing the attached Authorization for Use and Disclosure form. Charlene V***Executive Office Advocacy Team

Thank you for forwarding this complaint to CignaCigna has reviewed this complaint and resolved issue with customer on 10/05/2016. Erica M***Executive Office Advocacy Team

---- Forwarded message ----------From: Revdex.com of Metro Washington DC Date: Wed, Dec 21, at 10:AMSubject: Fwd: Complaint ID: ***To: *** *** ---------- Forwarded message ----------From: *** Date: Wed, Dec 21, at 9:AMSubject: Complaint ID: ***To: Revdex.com FYI,Cigna is not responding to, or trying to resolve this issueCharlene has all my personal information and was my original contact that denied to pay anything at all as secondary on the Hospital bill. *** ***

Hello-
This issue has been resolved and we have spoken to the customer directly to advise on the resolutionThank youTanya H***

Hello-
Thank you for notifying us of this complaintA full audit will be completed and I will follwith the customer directlyThank you
Tanya H***

I have sent coorespondence to the customer directly regarding the results
Thanks,
*** ***

October 8, 2015Dear Sir or Madam:
We are writing in response to your correspondence dated October 1, 2015, referencing *** *** ***’s claim for Long Term Disability (LTD) benefits*** *** was covered under her employer full- insured LTD group benefit policy ***This
policy was underwritten by *** *** *** ** *** *** (***) and sitused in the state of Massachusetts.*** *** raised concerns regarding ***’s adverse decision on her LTD claimPlease allow us this opportunity to address her concerns, explain our decision, and provide a current updateWith respect to *** ***’s employer’s LTD policy ***, in order for benefits to be payable, her medical records needed to support that her health conditions caused a functional impairment that would continuously prohibit her from performing the material duties of any occupation beyond months of benefitsThe policy’s “Definition of Disability/Disabled” lays out these requirements and is defined on page of the enclosed policyWhile her LTD benefits were approved for a time, continued LTD benefits were not payable to *** *** beyond June 16, 2015, because she no longer met the policy’s definition of DisabilityThis determination was based on our ongoing medical review of the relatively stable findings and low treatment intensity received from her providersAfter a complete medical review of the available records on file, it was determined that *** ***’s condition would not render her Disabled beyond the date referenced above, according to the terms of her LTD policyAs a result, no further benefits were payable and her claim was closedOn June 16, 2015, a letter was sent to *** ***, which explained our decision and provided information that may be helpful to perfect her claimWe understand that *** *** disagrees with our decision of her LTD claimAccording to our review, she has since filed an administrative appeal with our companyAt this time, her claim has been assigned to Appeal Specialist, Linda G., for reexaminationWe are fully committed to conducting full and fair reviews of all claims, and will consider any new information *** *** wishes to submitOnce all of the information she wants to provide has been collected and an appeal decision has been rendered, Linda will contact *** *** directly with the outcomeIn the meantime, should she have any specific questions regarding the appeal process, *** *** can always contact Linda directly at ###-###-#### for further assistanceThank you for allowing us this opportunity to respond to your inquiry regarding *** ***’s LTD claimWe hope the information provided is helpfulShould 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: [email protected] Fax: ###-###-####
Sincerely,
Rick P
Consumer Advocacy Specialist

Hello-
Thank you for forwarding this customer's complaintCigna has begun reviewing the complaint and will provide folldirectly with the customerTanya H***

*** *** ** ** *** *** *** ** * *** *** *** *** ** * *** *** *** *** *** *** *** ** ** *** ** *** *** *** *** ** *** ** ***
*** ***
I am rejecting this response because: Cigna called me twice during work hours of 9-10am when I was unable to answer, they never left me any contact information all I am able to do at this point is call the 1-numberMy problem still persist at this point in time
Regards,
Shane G***

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 her to give us permission to share our findings with the Revdex.com*** *** can grant this permission on behalf of her minor daughter by signing the attached Authorization for Use and Disclosure form. Alicia G*** Executive Office Advocacy Team

Revdex.com of Metro Washington DC
May (days ago)
to me
---------- Forwarded message ----------
From: ** ***
Date: Tue, May 20, at 4:PM
Subject: complaint #***
To: [email protected]
I
was informed this morning that my complaint has been resolved and my wife will have her surgery next Tuesday Thank you for your help
*** *** ***

Thank you for this information. I will have this account reviewed and reach out to the customer directly
Thank you,
Kelly M***

*** *** MD
Complaint: *** I am rejecting this response as there has been no resolution! The check fraud amount and associated bank fee is still outstanding months later

Thank you for this information. The claim will be review and outreach to the customer will be made when completed
Thanks,
Kelly M***

[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 the business's message on June (days ago) and I still haven't heard from themThis is what I was talking about in my original complaint, first they tell me one thing, I do what they said, they turn around and say that I did the wrong thing! And now it's radio silence, I haven't heard anything from them and this keeps getting more and more frustratingI need this to be resolved ASAPCigna, please be ethical and show a sense of urgency
Regards,
*** ***

Hello-Thank you for forwarding this claim to CignaWe we review this complaint and folldirectly with the customer.Tanya H***CignaExecutive Office of Complaints

Thank you for this inquiry. I will review and respond directly to the customer
Thank you,
*** ***

Good Afternoon,
Thank you for this information
I have sent complaint resolution correspondence to the customer on February 26,
Thank you,
Rae B***

Worst insurance ever! They deny everything and try to find loopholes out of paying! Took months of fighting to get them to pay my son's dentist billEvery excuse in the book! Finally the office was about to send me to collection, I had to threaten a lawyer to get this resolvedThen, they stopped paying my husband's bills and claimed it was because he had a second insuranceNo, he's only had cigna for the last yearsNothing had changedThey will try ANYTHING and EVERY EXCUSE to get out of paying bills