Since going on my insurance in Feb, my darling wife has been in a doctors office almost monthly- nothing major, just routine claims. All have been paid without issue.
Last night I received a denial of claim for the following reason:
"To process this claim, we need to know if you or your dependent(s) have other medical/dental insurance. Please send a copy of the explanation of benefits to the above address or contact member services."
This is a GE paid plan administered by Cigna. In the enrollment portion for GE, I must state if this is her primary/only coverage for rate eligibility.
I called the member services line and first clarified that this was her only coverage, After being assured that payment would be rendered I asked- after all of the previous claims, why are we getting this denial/question? Her response- "Because we didn't know.". What a brilliant answer on behalf of her insurance company.
Dear Cigna Administration,
I save GE money on a regular basis by always requesting generics, self treating, avoiding the doctor's office if I have a viral infection, questioning line item charges on my doctor's office invoice, etc. Why do you have to treat my wife's efficient and hard working doctor's office so poorly by holding up payment by fifteen days for a question you should have known the answer to- or that you should have sought out the answer to at the beginning of coverage.
You should know the cost of capital and realize that by delaying payment to this smaller organization, you are costing them a larger percentage than you've made by holding the money and additional fifteen days.
Shame on you for making doctors pay for your inability to manage your customer information.