O O.
BREACH OF TRANSPARENCY LAW-BEWARE
I went for regular doctor visit coded as "established patient visit" The doctor and facility are in-network-Cigna is frequently inconsistent call-to-call. I take notes and get cal reference numbers for all contacts. Often, the Cigna agents give misinformation, or are inconsistent in what they tell you is covered. I was told in one day that my deductible was met, it wasn't met, it was...I called ahead on 9/12 to ensure that my only responsibility for a specialist appointment was my $50 copay and was told it was for an in-network doctor. I called ahead before scheduling, to insurance co. and doctors office to ensure: (1) both were in-network (2) my only financial obligation would be the $50 specialist copay Because I have had issues with billing in the past, I checked the Cedars website, the Cigna website and called both the doctor's office and Cigna to make certain that the total cost would be the $50 copay. Two months later, I received a bill from Cedars for a "facility fee"! The bill said I was delinquent, although I had not received an earlier invoice. I checked the paperwork I signed, the Cigna website, the doctors listing, (he has no other office location), and non of these places list a facility fee for a standard office visit. This is fraud. I called the office and Cigna, and they state that the doctor is an "independent contractor". This still doesn't allow them to surprise patient with a facility fee without disclosing this information anywhere.