Zoox was initially helpful in getting Cigna to respond to the claims, and they let me know what additional information Cigna needed. Cigna gave inconsistent reasons for why my claims were rejected, including saying that I needed to resubmit due to my plan being 'handled by different department', and that a 'vendor outage... prevented many of [my] claims to come through’. There have also been at least two times that I have talked with Cigna over chat, only to have the chat die after the agent asks for more and more time.
Conversations with Cigna: https://docs.google.com/document/d/1dNDsCJ0_LSed4CmCmkSPQYMA-MpDPL6vg9lVRR1rgOY/edit?usp=sharing
Eventually, Zoox stopped responding as well, though I have a followed up a few times through email.
Is there any way to get Cigna to have a good faith review of my claims? Any government agencies that can help me, or outside companies that can help with the appeal?
toomuchtodo•7mo ago
cigna•7mo ago
toomuchtodo•7mo ago
2. File a complaint with the US Dept. of Labor's Employee Benefits Security Administration (EBSA):
The EBSA, a division of the DOL, handles complaints related to employer-provided health insurance. You can:
Call the EBSA: Toll-free at 1-866-444-3272 to speak with a benefits advisor.
Submit a complaint using the EBSA's online form: https://www.askebsa.dol.gov/WebIntake/
The EBSA will investigate the claim and may contact your employer or insurance provider for more information. You may be contacted for additional details or documents. If the EBSA finds that your rights under ERISA (Employee Retirement Income Security Act) were violated, they may take corrective action on your behalf. Keep copies of all documents and correspondence. You can follow up on the status of your complaint by contacting the EBSA at the phone number above.