Trapped between my doctor’s office, Cigna and Brown and Toland

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Trapped between my doctor’s office, Cigna and Brown and Toland

I just received a bill from my doctor’s office (who I did chose as my PCP) from an appointment a year ago; my Cigna Insurance Co. wouldn’t pay for the visit and a procedure. Apparently Cigna assigned me someone else a month after that visit and now claiming that they wouldn’t pay for my visit because I didn’t have refferal. But why did I need refferal when he is my PCP? And that’s only my first visit there, I fear that they’re going to refuse all the visits. Also, why the office hasn’t known for a whole year and hasn’t warned me?! Thank you so much!

Asked on June 2, 2009 under Malpractice Law, California

Answers:

L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 11 years ago | Contributor

Health insurance companies are notorious for just denying claims without taking the time to ask questions.  I would sit down and write them a letter with everything you just told me, including the date of your visit, how you found the doctor, etc.  Be clear and concise.  Call it a letter of Appeal, and write Appeal in big, bold letters at the top.  Hopefully, once they have all the information, someone will come to their senses and pay your bill!


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