I recently had to wear a heart monitor for two weeks. The company my in-network cardiologist uses for the hearth monitor happened to be out-of-network. I had no idea that the heart monitor company was out-of-network, or did I even have a choice in the provider – it’s the company my cardiologist uses for whatever reason (irrelevant, but likely because they can easily share information to my cardiologist).
My insurance company, through work, is Cigna, and is refusing to cover it as part of a in-network expense. I spoke with 2 customer service people on the phone, and they both agreed with me, that since I had no choice, that it makes sense to be in-network. So, I appealed, and lost my appeal on the basis that the heart monitor was out of network, and I should have known.
I am complaining to my Employer Benefits department, and they are looking into it. I know I can file an external appeal, file an ERISA complaint, and a complaint with the DOI (I live in NJ). But is there any other options I have? Or advice to win this, and get Cigna to cover the expense in-network?
submitted by /u/cydonia8388
[link] [comments]
I recently had to wear a heart monitor for two weeks. The company my in-network cardiologist uses for the hearth monitor happened to be out-of-network. I had no idea that the heart monitor company was out-of-network, or did I even have a choice in the provider – it’s the company my cardiologist uses for whatever reason (irrelevant, but likely because they can easily share information to my cardiologist). My insurance company, through work, is Cigna, and is refusing to cover it as part of a in-network expense. I spoke with 2 customer service people on the phone, and they both agreed with me, that since I had no choice, that it makes sense to be in-network. So, I appealed, and lost my appeal on the basis that the heart monitor was out of network, and I should have known. I am complaining to my Employer Benefits department, and they are looking into it. I know I can file an external appeal, file an ERISA complaint, and a complaint with the DOI (I live in NJ). But is there any other options I have? Or advice to win this, and get Cigna to cover the expense in-network?
submitted by /u/cydonia8388 [link] [comments]Read Morer/HealthInsurance