1 Jan, 2018 → by ClaimboUser713494
misleading from different employees on our policy
*SOLVED

2

Our daughter has to have jaw surgery because she has a very bad cross bite which could not be fixed by the ORTHO. The procedure needed 1 year of preparation before the actual surgery, so I call cigna to confirm our coverage to make sure that it is covered before we proceed and the doctor's office also did. We submitted the prior authorization (which they informed us that it will only be valid for 6 months but we should not have any problem re-submit it as the time get closer). IT was approved so my daughter went to the ORTHO to prepared for the surgery. As the date got closer, we submitted another PRIOR authorization as they told us to do so, then it was denied and said that we do not have such coverage. I call and the doctor's office call, my husband call his company (which the insurance thru my husband). Every time I talk to custmer service they said it was covered then I call the department that handle PRIOR AUTHORIZATION they said not covered and sometimes they hang up on me. Then, they told me since this is a new year my coverage for that procedure does not exist and if we have put the actual date then they would have cover it. We had the same insurance and make sure nothing was changed. So, some VIP call from CIGNA after I complain to the Better Business Bureau, but all he does is tell me that he is sorry that the employee at cigna has informed with wrong information. I am supposed to say oh, it is ok they make a mistake ... NOW I HAVE A BILL $20, 000.00 not $2000.00 but $20000.00 thank you. even now they can not type up any claim that I have to submit by myself without we having to call at least 4 times before we get paid. It is very frustrating and they even tell me that it does not matter that the claim was put in wrong because I was not getting paid anyway. I just think there is something wrong with this country insurance company.
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