Question:
Claim sent to Medical Review- Cigna POS, What does this mean?
I called my insurance this morning, Cigna POS, to check on the status of my RNY surgery claim, and they said my claim was sent to Medical Review yesterday 6/25/02. Does anyone know what this means? Is this good news or do I have a while to wait? THANKS!! — Stephanie H. (posted on June 26, 2002)
June 26, 2002
That's Cigna's process for evaluating your paperwork and making a decision.
Then it's usually reviewed by the medical director and processed.
— Cathy S.
June 26, 2002
There sending the claim to Medical Review to determine if the services will
be covered or not. Call back next week and they should have a response.
— Patty H.
June 26, 2002
I have Cigna also and my papers were send to medical review. Learn patience
because Cigna's poolicy states they have 30 days to make a decision in
medical reviews...
— lilmskitty
June 26, 2002
I work for a health insurance company. 'your claim was sent to medial
review' insurance translation---"Im the phone chick, I have no clue
as to where your paperwork is, but normally when things of this nature come
here, we send them to this group of people that have the power to decide
your future. Thank you, Call again" ---- Check back next week, they
may know more then. : )
— RebeccaP
June 26, 2002
It sounds like Rebecca is a little uhappy with her position of "phone
chick" :o)....anyway give them a week or so and try again, ask them
for the time frame to review your request, be persistant, but be polite
too.......
— Jennifer D.
June 26, 2002
Do not fret. Every insurance company has a "medical review."
That may mean a team of advisors, a medical director, a physician advisor,
etc. Of course the person who answers the phone is not trained or
qualified to make medical decisions, but he/she is trained to let you know
where your paperwork is. Cigna is usually pretty good at giving a response
within a reasonable amount of time. Give them a week or so and call back.
Writing to insurance companies and getting pre-approvals for WLS is what I
do for a living for 9 doctors in 2 states!
— Jennifer E.
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