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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Sounds like you didn't appeal within the time frame?  If so, there is fuck all you can do besides beg.

Anyway, I have Cigna and pediatrix was billed in network for me at Inova fairfax. [/quote]

Correct. I may engage the broker at the corporate level. There may be some leverage...[/quote]

I'm the one who recommended the broker. I didn't read carefully enough because I missed that you are out inside of the appeals window. You can try and see if the broker can help, but missing the claims deadline is usually a no go. Were you trying to negotiate on your own and that's why you missed the deadline? Or did the bill just come in?[/quote]

I will admit that my wife and I are wholly ignorant as to the insurance intricacies of the healthcare system. We tend to open Explanation of Benefits (EOB) statements and discard them, waiting for a bill from the provider before taking action. However, Cigna uses the EOBs as the starting point for the claims deadline, so we obviously learned our lesson on this.

My interest in considering counsel is that the EOB associated with this particular case of contention has a note to the provider -- not the consumer -- yet Cigna believes it was the consumer's responsibility to make the appeal.[/quote]

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