Cigna reversing payment?

[brbmake]

What is the name of your state? Colorado

I have had cinga thru my husband for years and years. When I started my new job 2 years ago they put me on Kaiser. There was a lady from Kaiser here that said it was basically just for physicals, but I could also use it. I specifically asked if it would in any way affect my Cigna. She said no that there was no way they could find out about each other unless I told them. In fact, this year I asked to drop it because I was so worried about something happening, and they did. However, before this, I went to Kaiser for a well woman's exam 2 years in a row, but that was it. Everything else I went to my regular dr. I had an ultrasound done at my regular dr in August of 17 for an ovarian cyst. Cigna paid their portion, I paid mine. Well, the other day I get a bill from my dr for the visit. Of course I think there is a billing error so I call them. They said that Cigna is reversing the payment because I have other insurance. I emailed Cigna and said this isn't true. Can they actually come after me for everything that was done for those 2 years? I am so frustrated. What can happen with this?

 

[PayrollHRGuy]

Kaiser was your primary once you had it and Cigna became your secondary. Turn it into Kaiser.

 

[brbmake]

Kaiser was your primary once you had it and Cigna became your secondary. Turn it into Kaiser.

Clearly they won't cover it though because it wasn't at Kaiser. So then what happens?

 

[cbg]

Then you become responsible for the bill. Which is what happens when you commit fraud.

 

[brbmake]

Then you become responsible for the bill. Which is what happens when you commit fraud.

Wow. Way to be rude. I was under the impression it was a secondary insurance that my work offered. I was expressly told by a Kaiser rep that it would not interfere. Perhaps I am not up to date on all of the insurance info out there as I don't work in billing, but attitude across a screen in uncalled for. If anyone is willing to offer helpful advice, I am all ears.

 

[Zigner]

You intentionally hid from Cigna the fact that you had an additional insurance provider. I don't see any rudeness in the stating of a fact.

 

[PayrollHRGuy]

First, if someone with Kaiser ever told you that they'd never find out they were wrong. Insurance company's all have a coordination of benefits system in place so people can't receive double benefits.

I don't deal with HMOs much but I've never seen a group policy application HMO or PPO that didn't have a specific question asking if you have other coverage.

 

[cbg]

Deliberately attempting to hide the fact that you have one insurance from another isn't fraud in your book? I wonder what is.

If the Kaiser rep actually told you that she should be fired.

 

[Zigner]

Deliberately attempting to hide the fact that you have one insurance from another isn't fraud in your book? I wonder what is.

If the Kaiser rep actually told you that she should be fired.

...and prosecuted.