Sometimes even the best plans don't function at 100% accuracy. What should you do when the claims process breaks down? If you cannot resolve your issue via www.myCigna.com, call the appropriate toll-free number on your card. For medical or dental questions, that number is 1-800-244-6224. For mental health or substance abuse questions, that number is 1-800-274-7603.
If you do not get satisfaction from that effort, you should next report your problem to the benefits office, Lineberger 212 or ext. 7018. Please provide documentation of the problem, such as doctor's bill and insurance Explanation of Benefits (EOB). You will be asked to sign a release form in compliance with federal confidentiality protection requirements before the University can contact a higher level claims representative or appeal a benefits decision for you.
Please note that errors are not always the insurance company's fault. Sometimes claims are not filed, are filed incorrectly by providers, or are delayed during the re-pricing process. Hospital emergency rooms and emergency room physician groups seem particularly prone to file in error and then employ hardball collection tactics.
If you suspect an error in insurance payment or provider billing, address it immediately. Never ignore follow-up bills and statements from providers. The longer a problem goes unsolved, the more difficult it is to correct. Once an account goes to a collection agency, it is almost impossible to correct.
NOTE: All information relative to group insurance is subject to change upon plan year renewal, June 1 each year.