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Health

AmandaRuth

(3,121 posts) Thu Oct 21, 2021, 09:01 AM Oct 2021

CIGNA denied a claim for a cholesterol screening

doc ordered a cholesterol screening for my 62 year old spouse. and CIGNA has denied. stated it was experimental, investigational or unproven. Is this the norm? Has anyone else experienced this? thank you for any response, I am trying to appeal, and CIGNA doesn't make it easy. I did file a complaint with the state commissioner.

also, I just noticed i lost my star. I'll take care of that today.

4 replies

= new reply since forum marked as read

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CIGNA denied a claim for a cholesterol screening (Original Post) AmandaRuth Oct 2021 OP

Sometimes this nothing more than a coding error. It should be covered. hlthe2b Oct 2021 #1

that kind of what i thought as well AmandaRuth Oct 2021 #2

You might try checking with your doctor's office too. hlthe2b Oct 2021 #3

Check doctor's office first. Coding is everything in medical billing now. halfulglas Oct 2021 #4

hlthe2b

(106,313 posts)

1. Sometimes this nothing more than a coding error. It should be covered.

Reply to AmandaRuth (Original post)

Thu Oct 21, 2021, 09:04 AM

Oct 2021

unless there is something about the tests ordered and methods that make it non-routine.

AmandaRuth

(3,121 posts)

2. that kind of what i thought as well

Reply to hlthe2b (Reply #1)

Thu Oct 21, 2021, 09:08 AM

Oct 2021

it has to be an error. thanks for the response and I will continue with my appeals

hlthe2b

(106,313 posts)

3. You might try checking with your doctor's office too.

Reply to AmandaRuth (Reply #2)

Thu Oct 21, 2021, 09:11 AM

Oct 2021

halfulglas

(1,654 posts)

4. Check doctor's office first. Coding is everything in medical billing now.

Reply to AmandaRuth (Original post)

Thu Oct 21, 2021, 10:29 AM

Oct 2021

One different number. Sometimes there is a difference between routine screen which should be free or seeking a medical diagnosis for a problem. A surprise bill isn't good for the BP but don't scream at anyone yet. But a cholesterol screen is not experimental.

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