Friday, December 21, 2007

CIGNA GOV'T SERV of CIGNA CORPORATION: MEDICARE PART B: illusory single-digit administrative overhead (OR JUST PLAIN INCOMPETENT) ??

FROM: Marsha V. Hammond, PhD: Clinical Licensed Psychologist, NC
E mail: cell: 404 964 5338
Billing address: -----------------Asheville, NC 28806
Medicare Provider Number: 2492758 / v653

TO: Michael D. Woeller, Executive Vice President and CIO
H.Hanward Hanway, Chairman & CEO, CIGNA Corporation
CIGNA CorporationDirector Access AddressOffice of the Corporate SecretaryTwo Liberty Place, TL17A1601 Chestnut StreetPhiladelphia, PA 19192

December 20, 2007

RE: inability to speak to any human at the Part B (outpatient and mental health) CIGNA Government Services, NC, provider tel #: 866 520 4007, CIGNA Government Services, even when utilizing ‘repeat dialer’ software for a busy signal

Dear CEO of CIGNA:

I have been a Medicare provider, Part B, in NC, for several years now. Recently, I have needed to change my address. I have sent in the paperwork four times over the past 4 months.

I have received 2 calls back from CIGNA Government Services employees in Nashville. The first call I received a couple a weeks ago, as associated with the 3rd filing to change my address; that employee indicated that I had not written on a line, ‘CIGNA.’ The second call back after the 4th submission of change of address, indicated that I had not filled in ‘CIGNA Government Services.’ I had no idea that your organization was composed of both ‘CIGNA’ and ‘CIGNA Government Services’ until I noticed the news article about the 17 yr old woman who was denied a liver transplant authorization by CIGNA---and so she died.

I cannot be paid until the address matter is settled. While it would appear to be a simple matter, it apparently is not. And there is no one to talk to. Only endlessly submitted paperwork is permitted.

I would like to know why I cannot get a human on the phone to answer my questions. I have called a.m.’s and p.m.’s, bearing in mind that I only have any possible chance of speaking to someone from 11-1 CST or 2-4, CST. This is what is declared to be acceptable business hours at the Medicare Provider number. I have asked many ancillary services if there is another way to get through: they state there is not.

Though there be 8 hour workdays for most people and other agencies, for CIGNA Government Services there are only 4 hours which providers who render Medicare services, can utilize.

As a further testament to my inability to interact w/ Medicare, Part B, CIGNA Government Services, I sent an e mail request to your online services associated w/ Part B on October 29, 2007. I received an answer back on December 18, 2007. That is almost 1.5 mos between my online submitted query and any answer. The answer was of no help as I had already moved through at least 2 or my paperwork submissions.

Many of my clients receive Medicare. I am dependent on being able to interface w/ Medicare.

And, as perhaps you know, NC has been engaged in a brutal mental health reform effort for the past 7 years. Providers are experiencing a very difficult time interfacing w/ the companies that pay for our services. Thus, difficulties w/ Medicare, Part B, which is perceived as being an efficient, single digit overhead entity, in terms of administrative costs, is not helpful-----if the single digit administrative costs are obtained by simply ignoring any interfacing w/ Medicare providers.

Instead of humans to talk to as per the provider number as above, there are:

1. chronic busy tones
2. messages stating that ‘no one is available’
3. messages indicating there to be an ‘exceptionally large call volume’
4. being permanently on hold during the business hours allocated for providers to call, w/ no one ever picking up.

I am not speaking about an occasional problem. I am speaking about a chronic inability to provide services to clients in an efficient manner as there is no one at your agency to answer questions and take care of business.

In that CIGNA is one of the largest and oldest insurance companies in the US, and in that recently it has received some quite shocking press re: the 17 yr old girl who died w/o her liver transplant, I am suggesting that perhaps your venerable organization make available services for which US citizens whom pay quite a lot of money.

I would like to hear from you about a functional telephone number. I would like to have my change of address attended to. My current billing address is as above: 168 Virginia Avenue, Asheville, NC 28806. And I would like to be paid.

All this makes me believe that John Edwards is entirely correct: we can no longer work with the insurance companies in this country. They are not to be included in any negotiations re: national health insurance. Please show me that I am incorrect in this perception.

Thank you for your help.


Marsha V. Hammond, PhD, Clinical Licensed Psychologist

cc: Mental Health Advocates, NC; NC State Legislature, Co-chairs, Legislative Oversight Committee as associated w/ mental health reform; NCPA; NCPolicy
Items of interest:
CIGNA Government Services' Role in Medicare
CIGNA Government Services, LLC is a wholly owned subsidiary of CIGNA Corporation – one of the nation's premiere health insurance companies. For more than 125 years, CIGNA has been helping people lead healthier, more secure lives.
Since 1966, CIGNA and its predecessor companies have administered the federal Medicare program. Today, CIGNA Government Services provides a variety of services for Medicare providers, suppliers and beneficiaries in 18 states and the U.S. Virgin Islands. Millions of Medicare beneficiaries and health care providers/suppliers rely on our quality services every day.

As a Part B and DME contracted carrier for the Centers for Medicare & Medicaid Services (CMS), we process and pay Medicare claims according to the Congressional laws and CMS rules and regulations. We do not determine who is eligible for Medicare.
CIGNA Government Services currently provides Medicare claims processing and support services for Medicare Part B and the states of Tennessee, North Carolina, and Idaho. On June 1, 2007, we assumed full operations for DME MAC Jurisdiction C (formerly DMERC Region C) for the states of: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia.
Item 2: Source: ABC NewsWESTWOOD -- A Northridge teenager awaiting a liver transplant died Thursday after she was pulled off of life support. CIGNA Insurance Company initially refused to cover the cost of the transplant for Natalee Sarkisian, saying the surgery was too experimental. On Thursday, friends, family and members of a nurses association held a protest outside CIGNA headquarters in Glendale, urging the insurance company to reconsider. But the decision came too late for Natalee. Just after six o'clock tonight, her condition worsened. Natalee's family took her off life support and she passed away. Read more:


Post a Comment

<< Home