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My husband had an amputation requiring me to take long term disability. After I returned to work, he received a prosthetic which would require me to transport him to therapy.

I could not take a second leave, so, I retired. He was one month short of Medicare eligibility, so, we took COBRA with my Cigna policy. For one year we have been dealing with the $13,000 bill for the prosthetic. We have provided all the documentation that they have requested.

When we call the billing department, the supervisor level agents agree that Cigna should be paying it and have no explanation for why they are not paying. We have filed their request for review and they still are not paying. At the time of service, they were paying other medical bills, including some associated with the prosthetic.

We are at a loss for how to resolve this and will soon be sent to collection by the provider. Where can we go for help?

Review about: Cigna Medical Claim.

Reason of review: Problems with payment.

Monetary Loss: $13000.

I didn't like: Do not uphold their obligations.

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h.kitchener
Columbia, South Carolina, United States #1334718

Find an attorney familiar with insurance company problems. Trying to make Cigna change their mind on your own is probably futile.

You are dealing with a large, bureaucratic organization that is unable to change course once it has made up it's mind for whatever reason. However, before spending money on an attorney, find in your insurance company info the section where it talks about appealing a decision on their part to pay or not, etc.

Then, follow their appeal procedures. Talking to their billing people does no good but all companies have a dispute or appeal process for situations like yours.

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