I submitted my claim clearly stating that I should be reimbursed, yet they paid the provider $1025 instead. After going through customer service, they agreed to send me the check. Then things changed and I got a new explanation stating they wouldn’t pay at all. Has anyone else dealt with something like this? It seems really messed up considering I based my treatment decision on Cigna’s initial approval. Shouldn’t they be held accountable for their mistakes?
Did you pay the provider before the check was issued? If yes, the provider should refund you for any overpayment.
Evren said:
Did you pay the provider before the check was issued? If yes, the provider should refund you for any overpayment.
Yes, I paid them upfront. When I called to ask about my reimbursement, Cigna said they sent the money to the provider instead of me, but the check was never cashed since I caught the mistake early.
@Oakley
Was there any explanation given for their denial? It makes me think they might have re-processed the claim when trying to send the new check, which could have led to it being marked as a duplicate and denied. Stuff happens with buttons getting pressed wrong, and they don’t seem motivated to check a denied claim unless someone pushes for it.
Why were they sending you the money? Did you settle the payment with the provider?
Blaine said:
Why were they sending you the money? Did you settle the payment with the provider?
Yeah, I settled with the provider and should have gotten the reimbursement.
That’s funny. Usually, the money goes to the provider for dental work and the patient gets compensated later. Did you talk to the dental office about getting the funds sent to you?
MissNicklaus said:
That’s funny. Usually, the money goes to the provider for dental work and the patient gets compensated later. Did you talk to the dental office about getting the funds sent to you?
I had Cigna cancel the check and told me they’d reissue it to me before it was cashed. But then they sent me a letter saying they were actually responsible for nothing.
It was a pay upfront deal, but Cigna did approve my claim so what gives?
@Oakley
Did you check if the services were actually covered by your plan?
Valen said:
@Oakley
Did you check if the services were actually covered by your plan?
I’m definitely asking for clearer documentation about what part of my claim isn’t covered and when the decision was made. The letter they sent didn’t explain anything. This service is listed as covered under my plan, and I received multiple statements from them showing their share was $1025 because they approved it… just never got the check.