- Jan 26, 2008
- 2,840
- Boat Info
- SOLD 2005 420 DA w/T-8.1S Horizons
- Engines
- 2018 Sea Hunt 255se w/Yamaha 300hp
In April of this year I had a signficant dirt bike accident in the mountains of Arkansas. I was transported to a trauma center hospital in Springfield, MO by helicopter. I had no say as to where they took me. It happens to have been a facility that was out of network for my Cigna heath insurance policy. While there it was deemed that I needed extensive surgery to my shoulder and that it was unsafe for me to travel back to Dallas to get this done. The surgery was performed at the MO facility. My policy states that I'm covered for out of network for emergency services.
Cigna has now denied the majority of the claim and is trying to leave me on the hook for over $145K. I've had it reviewed twice internally and they stand by their ruling however they have a dispute department that I can appeal to. This seems very one-side to me that they are the ones reviewing their own rulings.
So my question is, does anyone here have experience in this area? What should be my next course of action following the filing the dispute?
I've been dealing with this for 8 months and am a total loss.
Cigna has now denied the majority of the claim and is trying to leave me on the hook for over $145K. I've had it reviewed twice internally and they stand by their ruling however they have a dispute department that I can appeal to. This seems very one-side to me that they are the ones reviewing their own rulings.
So my question is, does anyone here have experience in this area? What should be my next course of action following the filing the dispute?
I've been dealing with this for 8 months and am a total loss.