CIGNA

Hello- We are reviewing this issue and will respond with more information.  Please see the attached form which will allow us to communicate the outcome and steps we will take to resolve with the Revdex.com if it is completed and signed by the customer.

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Received:Jun 29, 2015 12:53:08 PM
Expires:Aug 28, 2015 12:53:08 PM
From:CGI Consumer Advocacy
To:[redacted]@myRevdex.com.org
Subject:Response to Revdex.com ID [redacted]
Attachments:Revdex.com ID [redacted].pdf
Good 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]

Cigna is reviewing this matter and will respond with additional information.  We take patient confidentiality seriouslyProtecting 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. Jennifer Cohen can grant this permission by signing the attached Authorization for Use and Disclosure form. Charlene V[redacted]Executive Office Advocacy Team

[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. Cigna finally emailed me, and though I do not agree with them, they are the big insurance company and I know when it's time to quit thus I  must accept their resolution.
Regards,
[redacted]

Hello,
This complaint was received by Cigna's Executive Office Advocacy Team. We will research the issue and follow up with the customer directly.
Thank You,
Rafael P[redacted]

Please be advised that **. [redacted]'s request is in review. A response will be sent to her upon completion.
Thank you.

Thank you for this information.  I have reached out to the customer to address the issues.
Thank you,
[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]

Complaint: [redacted]
I am rejecting this response because:
------- Forwarded message ----------From: Revdex.com of Metro Washington DC <[email protected]>Date: Mon, Jul 13, 2015 at 9:10 AMSubject: Fwd: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted].To: [redacted] <[redacted]@myRevdex.com.org>
---------- Forwarded message ----------From: [redacted] <[redacted].net>Date: Sun, Jul 12, 2015 at 9:15 AMSubject: Re: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted].To: "[email protected]" <[email protected]>
The complaint is not resolved.  CIGNA has not responded.Sent from my [redacted]
Regards,
[redacted]

Thank you for this information.I have researched the issue and have confirmed it has been resolved.Thank you,Nicole

Hello,
Thank you for this information.
I will be in review of the issue and will respond directly to the customer.
Thank you,
Nicole P[redacted]

I have been advised that a written response has been faxed to the Revdex.com today.

Thank you for this information.
I have spoken with the customer. I am waiting on an Explanation of Benefits to send to the facility. Once completed, I will follow up with the customer and send correspondence.
Thank you,
Nicole P[redacted]

Hello,
 
Cigna has received this complaint and will reach out to the customer on Monday, March 9, 2105, to resolve the customer's issues.
 
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:      Cigna does not say what viable options I can go with, they just reject everything.  I believe there were no other viable options in my case except to do nothing. I can not get though to Cigna on the phone for some reason, their answering machine keeps saying "all line are still in use". I tried to call 11-14-2016 @ 11:40 AM, it is now 12: 05 PM and nobody has answered their phone yet?      I am send a letter to review the claim again to the "Cigna Dental Appeals" address.       Also, I just found out from the Advocacy Group that works for my company Nisource that they said the Cigna received a letter frommy dentist that my dentist recommended a partial or full denture and not Implants. This is the first time I heard this in 6 months of fighting this claim. I just called my dentist office and talked to them and they said they DID NOT recommend a partial or dentures, they recommended Implants.Please do what you can. Cigna need to honor their agreement with my company Nisource and stop all this paperwork nonsense.[redacted] ###-###-####Complaint: [redacted] Cigna Tracking #[redacted]       Account NiSource    Account # [redacted]

Thank you for forwarding this complaint to Cigna. Cigna has reviewed this complaint and verbal resolution has been sent to the customer on 01/09/2017. Erica M[redacted]Executive Office Advocacy Team

Thank you for this information.I will be researching this issue and will respond directly to the customer.Thank you,Nicole P[redacted]

Thank you for the information. Cigna has resolved this issue and will be contacting the customer directly. In order to provide specific policy information, the customer will need to complete the attached Authorization of Disclosure of Protected Health Information.

---------- Forwarded message ----------From: M[redacted], Erica J HHHH Date: Fri, Jan 27, 2017 at 3:25 PMSubject: [redacted] #[redacted] Thank you for forwarding this complaint to Cigna. Cigna has reviewed this complaint and an outreach was made to the member on 01/27/2017.  I provided a resolution to the customer regarding her concerns . The customer is satisfied. Erica M[redacted]Executive Office Advocacy Team

February 7, 2017Dear [redacted],We are writing in response to your correspondence dated January 30, 2017, regarding [redacted]’s claim for Long term Disability (LTD) benefits. [redacted] was covered under her employer provided, fully insured LTD policy VDT [redacted], which was underwritten by...

[redacted], and issued in Delaware.[redacted] raised concerns regarding the decision made on her LTD claim. According to our records, [redacted] initially went out of work on January 5, 2016. Our claim manager requested and obtained medical records from [redacted]’s treating medical providers. This information was reviewed with our Expert Resources Group, and the claim manager determined that the information provided was insufficient to support a functional loss that would have precluded [redacted] from being able to perform her occupational duties past November 17, 2016.[redacted] appealed this decision as of December 2, 2016. Her entire claim file, including the information sent in support of her appeal, was referred to our appeals team for them to perform an independent review of our previous decision. The information on file was again reviewed with our Expert Resources Group, and as of January 25, 2017 the determination was made by our appeal specialist that our previous decision should be overturned. A letter was sent to [redacted] on January 25, 2017, advising her of the decision and notifying her that our claims team would be in contact within 10 days to discuss the reopening of her LTD claim.We called and spoke with [redacted] on January 30, 2017, advising her of our decision and offering to assist further should she not be contacted by our claims team. Should she have any further questions, she may feel free to reach out to our LTD team directly at ###-###-####.In addition, should you or her have any questions or would like to discuss this matter further, please feel free to contact me directly at ###-###-####.Sincerely,Eric F. Compliance Specialist