Subject: Unexpected Cost Increase for Therapy Sessions
Hi everyone,
I’ve been in therapy since January 10th, and I was initially relieved when my insurance, Cigna PPO, indicated that my sessions would cost $0 through the Headway platform. However, after completing four sessions, I received an email stating:
“After reviewing your claims, Cigna informed us that your session cost is higher than our initial estimate.”
Now, they are asking me to retroactively pay $35 for each of my previous sessions, as well as for all upcoming ones. This unexpected charge is really disheartening, and I’m wondering if there’s any way to contest it. It feels quite overwhelming to suddenly have to cover these costs.
Any advice or guidance would be greatly appreciated! Thank you!
I’m sorry to hear you’re dealing with this unexpected charge. It can be really frustrating when insurance issues arise, especially after you’ve been led to believe your sessions would be covered at no cost. Here are some steps you can consider taking to push back against this retroactive payment request:
Review Your Plan Documents: Understand your policy’s coverage for therapy services. Look for any details regarding provider networks and costs associated with services. If Cigna PPO is supposed to cover these sessions, it’s important to have this information on hand.
Contact Cigna Directly: Reach out to Cigna’s customer service to get clarification on why there’s a discrepancy. Ask for an explanation of the billing process and why the initial estimate was incorrect. Sometimes, a direct conversation can resolve misunderstandings.
Document Everything: Keep a record of all communications with both Cigna and your therapist’s billing department. Note dates, times, and the names of the representatives you speak with. This documentation may assist you if you need to challenge the charges formally.
Obtain a Breakdown of Charges: Request a detailed breakdown of what your insurance is now charging you for each session. Sometimes these charges can be negotiated or adjusted if you can provide evidence of prior communications.
Appeal the Decision: If you believe you were given incorrect information initially, ask Cigna about the appeal process. You have the right to appeal any decision regarding coverage that you believe is unfair.
Check Network Participation: Make sure the provider you are seeing is considered in-network by Cigna. If they are out-of-network, the costs may be higher than you anticipated. If you were under the impression they were in-network, this might be grounds for negotiation.
Seek Assistance from a Supervisor: If you aren’t getting anywhere with the initial representatives, don’t hesitate to ask to speak with a supervisor or a claims specialist. They may have more authority to help resolve your issue.
Consider Consumer Assistance Programs: If your situation doesn’t resolve, you might want to look into state consumer assistance programs that can help mediate disputes with insurers.
I hope you are able to resolve this issue quickly and continue with your therapy without additional financial stress. Good luck!