The customer service team at Cigna Healthcare continually works behind the scenes to ensure members get the care they need, going above and beyond to resolve any issues and provide support.

Here are three examples of the ways Cigna Healthcare’s customer service advocates made a significant impact on people’s lives.

Resolving denied claims for a concerned mother

Brandi* recently contacted Cigna Healthcare because claims for her daughter’s care had been denied. She had begun receiving bills from providers and was worried they would cancel upcoming visits.

Customer service analyst Tamika assisted Brandi, whose family is covered by Cigna Healthcare along with a secondary health insurance carrier. Upon reviewing the notices, Tamika saw that the claims denials were caused by an external issue that had resulted in Cigna being designated as Brandi’s secondary carrier.

Tamika updated Brandi’s Coordination of Benefits information to show that Cigna is the primary insurance, then contacted the necessary Cigna Healthcare teams to get Brandi’s claims adjusted so they could be processed immediately. She also contacted each of the daughter’s health care professionals to confirm they had Cigna Healthcare listed as the primary insurance and the other insurance as secondary. She also ensured all accounts were placed on hold for 30 business days to allow time for payments to be received and processed, and confirmed that no upcoming appointments would be canceled.

Tamika subsequently followed up with the health care professionals to confirm they had submitted the Cigna Explanation of Benefits to the secondary insurance carrier for processing.

“I’ve never had such amazing service by any insurance company, and I’ve worked with insurance companies for over 20 years,” Brandi said. “I really appreciate [Tamika’s] help… she is an amazing rep.”

Finding the best available care during Hurricane Milton

Myrtle* called Cigna Healthcare to ask about affordable options for treating her son’s football-related shoulder injury. She believed he needed an X-ray, but his pediatrician’s office was only treating patients with extreme emergencies due to Hurricane Milton.

Mrytle spoke with customer service analyst Melana, who promised to remain on the phone until she found the best care option for Myrtle’s son.

“If it meant we stayed on that call for five minutes or 50 minutes, [Melana] was going to persevere until the end, until she really provided a solution that was acceptable to me and to my family,” Myrtle said.

Melana asked about the urgency of Myrtle’s son’s injury before reviewing every treatment option – including emergency room, urgent care, and convenience care clinics – while ruling out any locations that could not offer an X-ray. Melana also offered to identify another primary care provider who might be able to see Myrtle’s son sooner. Melana then reviewed Myrtle’s benefits, copays, and deductibles to provide cost estimates of each option. After evaluating that information, Myrtle decided to take her son to an urgent care center.

“[Melana] provided me a sense of peace and comfort that we reached the best decision, together,” Myrtle said. “She deeply cared about what was going on with me and my family’s life and was really concerned about getting to a solution to help us in that current time of need.”

Melana asked if Myrtle would like a follow-up call scheduled to check on her son and the rest of her family. Myrtle accepted, and Melana followed up three days later.

“She is just an outstanding person, a wonderful human being,” Myrtle said. “I can’t thank [Cigna Healthcare] enough for Melana and for her commitment to providing the best customer care that she could to me.”

Easing stress over dental claim delays

Polly*, a Cigna Healthcare dental customer, needed to schedule additional dental services but was unsure about her remaining benefits due to a delay in her provider submitting a previous claim. She reached out to Cigna Healthcare and connected with customer service senior representative Martha.

“Polly explained that she had already contacted her provider, and they said they had resubmitted the claim for her,” Martha said.

However, Martha was unable to locate the claim. She assured Polly that she would contact the dental office and ask them to resubmit the claim directly to her, so she could track its progress and notify Polly when it was fully processed.

“Polly was pleased to know that she didn’t have to stress any longer about this situation and that she would get a call back once everything was completed,” Martha said.

Martha soon received confirmation that Polly’s claim had been fully processed, and Polly scheduled the additional procedures.

“Cigna Healthcare isn’t just here to provide benefits and process claims,” Martha said. “We are also here to help make members’ lives a little easier by handling situations like this – taking the legwork off the customer whenever we can.”

* Names have been changed to protect the privacy of the customers in this article.

This content was created with the assistance of AI tools. It was reviewed, edited, and fact-checked by Cigna Healthcare's editorial team.