In 2020, my family actually managed to hit our out-of-pocket limit; I had an unexpected surgery and my wife got pregnant and gave birth – so it all added up! What I found though was that almost as soon as we hit it, our insurance company (Cigna) suddenly started conveniently sending back claims for BS reasons (for instance, saying a medical code is incorrect, even though its one they’ve approved a dozen times before). Eventually they started ignoring them altogether!
As it stands, I have 6 pediatric appointments for my newborn that I paid for 100% out of pocket, and which Cigna is supposed to reimburse me for at least part of.
I’ve tried sending it through their online system multiple times – they never show up. I call them about it and customer service shrugs their shoulders, say “try mailing it in or faxing it”. I mailed them hard copies of the claims in early January – almost 3 months ago – still nothing. When I call and ask about it, they tell me they don’t see it in their system. I am getting my hands on new copies and will try faxing them over, but I’m not super optimistic.
Is there anything I can do to elevate the case and get these claims processed? It’s one thing to deny them, but they are acting as though they don’t see them at all.
submitted by /u/Anne-Nani-Moose
[link] [comments]In 2020, my family actually managed to hit our out-of-pocket limit; I had an unexpected surgery and my wife got pregnant and gave birth – so it all added up! What I found though was that almost as soon as we hit it, our insurance company (Cigna) suddenly started conveniently sending back claims for BS reasons (for instance, saying a medical code is incorrect, even though its one they’ve approved a dozen times before). Eventually they started ignoring them altogether! As it stands, I have 6 pediatric appointments for my newborn that I paid for 100% out of pocket, and which Cigna is supposed to reimburse me for at least part of. I’ve tried sending it through their online system multiple times – they never show up. I call them about it and customer service shrugs their shoulders, say “try mailing it in or faxing it”. I mailed them hard copies of the claims in early January – almost 3 months ago – still nothing. When I call and ask about it, they tell me they don’t see it in their system. I am getting my hands on new copies and will try faxing them over, but I’m not super optimistic. Is there anything I can do to elevate the case and get these claims processed? It’s one thing to deny them, but they are acting as though they don’t see them at all. submitted by /u/Anne-Nani-Moose [link] [comments]Read Morer/HealthInsurance