Cigna offers members a process to address complaints and appeals. Members may have questions related to claim payment, eligibility, coverage determinations, and other procedural or administrative issues. They may also have questions about other aspects of care and services received in your office, which may include your billing policies, routine and emergency appointment wait times, sterilization protocols, or quality of care.
The member, a representative of the member, or a dentist designated by the member can initiate a complaint or appeal. Network providers are contractually required to cooperate with Cigna in resolving member complaints, including timely responding to requests for information and/or records.
Cigna Customer Service is available to assist a member with a question or problem about any matter relating to services and/or coverage. Customer Service may be contacted by calling 800.Cigna24 (800.244.6224) or the telephone number on the member’s ID card, by Fax: 866.870.3842, by email: DenisonAppealTeam@Cigna.com, or by writing to the following address:
Cigna Dental Health, Inc
PO Box 188044
Chattanooga, TN 37422-8044
Cigna is deeply committed to responding to Member inquiries and complaints promptly and fairly. Customer Service or the National Appeals Unit (NAU) will respond upon the initial contact or respond to the member by the end of the next business day. For problems that cannot be resolved promptly, the member, their representative, or the network provider on the member’s behalf may access the complaint and appeal process. The above processes are governed by state law and will vary accordingly.
Cigna nondiscriminatory statement: No plan employee shall retaliate or discriminate against a member (including seeking disenrollment of the member) solely on the basis that the member filed a grievance. Instances of such retaliation or discrimination shall be grounds for disciplinary action against the employee (including termination).
For California residents: Accessing the Cigna Member Grievance Form is straightforward. Visit our website at https://www.cigna.com/cignacompanynames/cigna-in-california and scroll down to the section “Cigna Dental Health of California, Inc., Grievances and Appeals” to access the California-specific forms, which are available in English and non-English languages. Additional complaint, grievance, and Independent Medical Review information is available in English and non-English on the Department of Managed Health Care website: www.dmhc.ca.gov. If you prefer a hard copy, you may obtain one by submitting a written request to:
Department of Managed Health Care
Attention: HMO Help Notices
980 9th Street, Suite 500
Sacramento, CA 95814
Additional Rights for California residents:
The California Department of Managed Health Care regulates health care service plans. If you have a grievance against your health plan, telephone your health plan at 800-244-6224 (Dial 711 (TTY) for the hearing and speech impaired) and use your health plan’s grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. Should you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. The department also has a toll-free telephone number (888-466-2219) and a TDD line (877-688-9891) for the hearing and speech impaired. The department’s internet website, www.dmhc.ca.gov, has complaint forms, IMR application forms, and instructions online.