I have Cigna through my employer. It says on my benefit summary that an MRI done in an in-network facility is covered at 100%. I had an MRI at an NYU Langone outpatient facility two weeks ago. I did confirm with both NYU Langone and Cigna to make sure the facility is in-network. Two weeks after I’ve had the appointment, I received a claim notification through the Cigna website that said I owed $900 for the MRI. I called Cigna immediately and spoke with two agents.
Agent #1: She agreed that this should have been in-network. The MRI claim was processed as an out-of-network service. She put in a reevaluation request to the claims department and told me to wait 5-10 business days.
Agent #2: He also agreed with the previous agent, and he was kind enough to call NYU Langone’s billing department for me. NYU has agreed to submit a new claim, and they have put a hold on my account. NYU said that it might take 30 days for the new claim to be submitted and processed. NYU also said that this should be in-network.
I guess all I can do now is wait for the new claim to come out. Is there anything else for me to do? Do these things happen regularly where in-network visits are filed as out-of-network? Should I file an appeal?
submitted by /u/Snoo26013
[link] [comments]I have Cigna through my employer. It says on my benefit summary that an MRI done in an in-network facility is covered at 100%. I had an MRI at an NYU Langone outpatient facility two weeks ago. I did confirm with both NYU Langone and Cigna to make sure the facility is in-network. Two weeks after I’ve had the appointment, I received a claim notification through the Cigna website that said I owed $900 for the MRI. I called Cigna immediately and spoke with two agents. Agent #1: She agreed that this should have been in-network. The MRI claim was processed as an out-of-network service. She put in a reevaluation request to the claims department and told me to wait 5-10 business days. Agent #2: He also agreed with the previous agent, and he was kind enough to call NYU Langone’s billing department for me. NYU has agreed to submit a new claim, and they have put a hold on my account. NYU said that it might take 30 days for the new claim to be submitted and processed. NYU also said that this should be in-network. I guess all I can do now is wait for the new claim to come out. Is there anything else for me to do? Do these things happen regularly where in-network visits are filed as out-of-network? Should I file an appeal? submitted by /u/Snoo26013 [link] [comments]Read Morer/HealthInsurance