1. Confirm the Cigna benefit plan for ER coverage, including for physician bills. Compare the benefit plan with how the claim was processed.
2. If Cigna has a contract with the ER group, then said contract would normally protect you from being billed for the balance. This then becomes a Cigna issue to resolve since it’s their contract with the ER group.
3. If Cigna has a contract with the hospital but not with the ER group, then they may be will willing to pay up to the billed amount since you did not “intentionally” go out of network.
4. When you call Cigna Member Services ask for a supervisor or manager as many Reps are inexperienced in resolving these types of ER claim issues.
5. Ask for procedures to filing an appeal. There are established time frames for this that may have passed.
6. File a complaint with the Utah Insurance Department. They may be able to resolve this with Cigna depending upon how you are covered. https://insurance.utah.gov/complaint