Health Advocacy Program – Cigna

Cigna’s Health Advocacy Program

Cigna offers valuable health advocacy services to help you and your eligible family members (including spouse, dependent children, parents and parents-in-law) resolve healthcare, health insurance, or medical bill challenges. Health advocacy services are provided by experienced clinicians and insurance professionals Monday through Friday, between 8:00 a.m. and 12 midnight ET at 866.799.2725.  For more details, you may view the Health Advocacy – Services Program Description or view the Health Advocacy-Brochure.

Clinical Services

  • Provide information and resources about medical terms, tests, medications, and treatments
  • Help identify physicians, hospitals, dentists, and related healthcare providers
  • Help research questions about diagnoses, treatments, and available support systems
  • Help customers with rare or a complex medical condition to identify top medical institutions or specialized medical programs
  • Assist with prescription drug issues
  • Coordinate hospice, home care, and other services for terminally ill individuals

Senior Care and Special Needs Services

  • Locate eldercare facilities, group homes, nursing homes, and adult day care
  • Locate homemakers, home health aides, private duty nurses, and rehabilitation services
  • Locate physicians who make house calls for people who cannot easily get to the doctor’s office

Administrative Support Services – Benefits and Claims

  • Provide assistance with benefits, coverage, eligibility, claims and related paperwork
  • Assist with preauthorization and predetermination process
  • Help with eligibility, denials, and incorrectly applied provider coding deductibles and co-pays
  • Help resolve questions about whether services are condition-specific or related to preventive care
  • Help customers understand the process for obtaining coverage for medical equipment, devices, and supplies
  • Help customers through the review and appeals process

Financial Support Services

  • Provide assistance regarding current benefit costs and the cost of alternative approaches
  • Provide comparative cost estimates for the service in question
  • Negotiate fees with healthcare providers prior to services to lower the customer’s out-of-pocket costs
  • Review questionable bills to catch duplicate or erroneous charges

Medical Bill Saver™ Scope of Services

Personal Health Advocates work with health care professionals to negotiate a discount for customers on non-covered medical bills over $400, helping to reduce their out-of-pocket costs.

  • Negotiate with physicians, dentists, hospitals, surgery centers and other health service providers
  • Provide a written summary of the outcome of the negotiation
  • Secure written provider sign-off on the terms and conditions negotiated on the customer’s behalf
  • Provide education to clarify overall health plan and how to maximize benefits and savings