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May 15, 2015Dear [redacted]:We are writing in response to your correspondence dated May 4, 2015, regarding [redacted]’s claim for Short Term Disability (STD) benefits. [redacted] was covered under her employer provided, self-funded STD plan [redacted], which was administered by [redacted]).
[redacted] has expressed her concerns regarding the management of her claim and customer service. We appreciate the opportunity to address her concerns.
As outlined in our previous letter dated April 28, 2015, [redacted]'s claim's claim was received on February 25, 2015, and benefits were initially approved on March 24, 2015, Ongoing STD benefits were approved after receiving updated medical information On April 2, 2015 from her treatment provider that included the following:
• Family Medical Leave and Medical Request Form (MRF) dated March 31, 2015;
• Office visit note dated March 17, 2015; and
• Work/School Status Note
Based on the review of the above medical information, STD benefits were extended and a benefit check was released on April 6, 2015, for the period of March 22, 2015 through April 7, 2015. Our office did receive duplicate medical records from [redacted] on April 6, 2015, except for a March 9, 2015 office visit note.
On April 16, 2015, our office received an office visit note dated April 7, 2015; however, it was incomplete. Therefore, on April 17, 2015, we requested [redacted]'s medical records from April 7, 2015 to the present and the completion of a MRF. Our office received the requested medical information on that day, and they were reviewed on April 22, 2015. It was at that time it was determined that [redacted]'s benefits were payable through April 27, 2015. However, our office received an email from her employer indicating that she returned to work on April 22, 2015, As a result, STD benefits were only payable through April 21, 2015. [redacted]'s final benefit check was released on April 27, 2015 for the period of April 8, 2015 to April 21, 2015.
In addition, we regret any stress caused to [redacted] due to the lack of customer service and effective communication during the claim review process. We are committed to customer service, and agree that effective communication is very important, especially when dealing with one's livelihood.
Also, we understand that [redacted] would like to be compensated for stress, late fees, and past due bills. However, her STI) plan does not provide for additional compensation outside of the Disability benefit. If she still has not received her STD benefit checks, she may contact our office to discuss possible alternative methods to receive benefit payments. We would like to advise that any alternative would have to be discussed and approved by her employer,
We appreciate the opportunity to be of service and hope that the information provided has been helpful. Should you have any further questions or concerns, please do not hesitate to contact our office,Sincerely,Bianca W[redacted]Consumer Advocacy Specialist
Please be advised that a final response was sent to customer [redacted] on today 3/17/2014 via mail. Please allow mail time for receipt.
Thank you.
We have sent a response to the customer today in regard to Revdex.com # [redacted].
---------- Forwarded message ----------From: [redacted] <[redacted]@cigna.com>Date: Mon, Apr 17, 2017 at 1:09 PMSubject: #[redacted] Revdex.com ComplaintTo: Revdex.com Thank you for forwarding this complaint to Cigna. Cigna has reviewed this complaint and two outreaches through telephone were made to the customer to provide the resolution on April 7,2017 and April 11,2017. I left my contact information but the customer did not return the call. I have sent the customer a resolution letter providing the information requested. If the customer has any questions, my contact information has been made available via the letter. Erica M[redacted]Executive Office Advocacy Team --------------------------------------------------------------------------...⇄ NOTICE: If you have received this email in error,please immediately notify the sender by e-mail at the address shown. This email transmission may contain confidential information. This information is intended only for the use of the individual(s) or entity to whom it is intended even if addressed incorrectly. Please delete it from your files if you are not the intended recipient. Thank you for your compliance. Copyright (c) 2017 Cigna
Thank you for this information.
I will be researching the issue and will respond to the customer once complete.
Thank you,
Nicole P[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.]
Better Business...
Bureau:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me as far as returning the $30. However, the money you charge for the services covered should be illegal and what Cigna advertises is false.
Regards,
[redacted]
Thank you for forwarding this complaint to Cigna. Please be advised a written response was sent to the customer on 4/30/2015 and again today (6/4/2015).
Charlene V[redacted]
Executive Office Advocacy Team
Hello,Cigna has received this complaint at the Executive Office Advocacy Team, and will follow up with the customer directly for resolution.Thank You,Rafael P.
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. Eva can grant this permission by signing the attached Authorization for Use and Disclosure form.
[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: Erica called me on 12/4 to say records have arrived and she would call me with results by 12/8. This is 12/12 and she still has not called me. It has been over 15 months and still no resolution.
Regards,
[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. Jaime can grant this permission by signing the attached Authorization for Use and Disclosure form.
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. [redacted] can grant this permission by signing the attached Authorization for Use and Disclosure form.
Thank you for forwarding this complaint to Cigna. Cigna is reviewing the complaint, and an acknowledgement letter was sent to the customer on December 19, 2016.Rae B[redacted]Executive Office Advocacy Team
We have received the Revdex.com complaint from this customer and have sent out an acknowledgement letter as of today. I have attached a copy of the authorization for disclosure form that was also sent to the customer.
We are actively working on this complaint and have been in contact with the customer via phone. We hope to bring this to some type of resolution next week. Revdex.com complaint # [redacted].
I will have this addressed and outreach to the customer regarding the payments.
Thank you,
Kelly M[redacted]
Thank you for forwarding this complaint to Cigna. Cigna has reviewed this complaint and resolution letter has been sent to the customer on 06/23/2016.
Charlene V[redacted]
Executive Office Advocacy Team
Hi Cigna is reviewing this case and will reply pending the customer authorization to release.Thank youRandy 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 as Answered]
Complaint: [redacted]
I am rejecting this response because:
Regards,
[redacted]
Cigna has completed our review of this Revdex.com request
and a final resolution has...
been communicated to the customer.