Please note, I filed a complaint with Consumer Affairs against CIGNA. CIGNA asked for information to substantiate my negative review to see if they could help resolve my issue. I thought I would share my response with you: To Whom It May Concern, This email is in response to the correspondence between myself and your representative regarding a negative rating that I placed on the Consumer Affairs website for CIGNA. After reviewing my records, I was able to find the following: In August of 2016, I received a letter from eviCore (your partner company) that was dated 8/3/16. This letter was regarding an MRI on both knees that was requested by my orthopedic surgeon for severe pain that I was having in BOTH of my knees, along with an abnormal growth that was found above my left knee. eviCore's response to the request for the MRIs was: “After reviewing the information we have, we’ve determined that this service is not medically necessary.” After receiving this response, I had to take time out to contact my third party administrator to get approval for the MRIs, which delayed treatment. The MRI eventually got approved, and it was found that I had torn medial meniscus' in BOTH knees, and an abnormal growth above my left knee. Surgery was performed on my left knee in September of 2016, and the growth was removed, I have NOT had the surgery on my right knee as yet, which I will explain shortly. The growth was removed during surgery and sent out for biopsy. I was diagnosed with Sarcoidosis. During the interim of all this, I was also having problems with my shoulders, moreso in my right shoulder, and the same orthopedic surgeon ordered an MRI on my right shoulder. Please note: this was during pain management, and after cortisone injections, a suprascapular nerve block which only lasted for five weeks, medicinal therapy, and 4 weeks of physical therapy with ATI in (city), Indiana which worsened my condition, and reduced my range of motion significantly. I was advised by my pain management doctor to cease physical therapy. I was also told to report back to the orthopedic surgeon, because in his opinion I had expended ALL options or treatment plans that I could, and surgical intervention was necessary. I went to my orthopedic surgeon, and that day he did a set of x-rays and ordered an MRI of my right shoulder. I received ANOTHER letter from eviCore dated 8/20/17, stating: “After reviewing the information we have, we’ve determined that this service is not medically necessary.” The letter also states: “Treatment might include: 1) rest, ice, wraps, and/ or propping up of your affected body part, 2) drugs that treat swelling and/ or pain, 3) oral or injected steroids, 4) a home workout program and/ or a formal in office workout program, 5) bracing, splinting, and/ or casting, and/ or 6) injected treatments. Your records do not show that you failed to improve following a 6-week trial of treatment.” AGAIN, I was forced to contact my TPA to get approval for THIS MRI and this was after a peer to peer was conducted with my doctor and CIGNA. The TPA approved this MRI, and as of the date of this correspondence, I am 8 weeks and 1 day POST-OP, as it was found that I did in fact need surgery on my right shoulder. The fact that my doctor's requests or recommendations were not sufficient enough to get the testing completed at the time that the requests were made is inexcusable. I have a medical condition that is causing me a great deal of joint problems as well as significant pain, and CIGNA and eviCore should have thoroughly reviewed my file, ensuring that I had followed my doctors' orders to the letter, and should have approved my MRIs WITHOUT QUESTION! Everything that I have been seen for by my doctors has been substantiated and validated, so I cannot understand why my insurance company - aka CIGNA - would deny and thus delay my treatment. Your customer service is absolutely horrendous, as when I called regarding the MRI denial on my shoulder, I was told by a gentleman named Darren that CIGNA wasn't even my insurance company - that my insurance company is S & S (who is a TPA), and I was offered no recommendation or resolution to my problem. When I call CIGNA and am asked to enter my group number, it states that the group number is not recognized. When peoples' health and lives are at stake, and they pay you for service, that service should not be questioned, ESPECIALLY if its ordered from a licensed physician, it's within the scope of his expertise to order said service, and what was requested was within the scope of the law. IT WAS AN IMAGING TEST! It was needed for the surgeon to see the deeper tissue in my body, because it was unable to be seen via x-ray. There is absolutely NOTHING you can do to resolve this situation. What's done is done. I would hope that, in the future, your partner company eviCore will take these matters into consideration and be more steadfast to act in the best interest of the patient. My rating on Consumer Affairs will remain unchanged, because I do not foresee your services improving in the future. Your ratings have been ridiculously low for years, and if you truly cared, you would have improved your services prior to my negative review. Should you feel it necessary to contact me regarding this information, please feel free to do so using this email address. Thank you! Respectfully, Please note: I have also filed a complaint with my state insurance commission. NEVER take no for an answer!! Peace...