Complaint Review: American Specialty Health - San Diego California

My complaint is with my insurance company Cigna and "American Specialty Health" 

My daughter and I have seen the same Chiroprator for 4 years.  According to our health Insurance coverage we are allowed 30 visits per year each!   Last year my daughter saw this Doctor 10 times.  Out of the 10 visits *2* I paid per our deductable.  That left 8 visits for Cigna to pay for the whole year!  They have paid only 3 and the last 5 have been a nightmare for the doctor's office and myself trying to get paid!!! 

"ASH" denied a claim on 8/23/13 as not medically necessary & asked for more information.  The doctor's office supplied the information requested.  ASH then denied the claim again, but in the same letter authorized a month of new visits & treatments!!!?????    Since that point it has been an unbelievable battle!  Up until Febuary 13, 2014 none of my daughters claims would even show up online as submitted!  I stood with the billing supervisor 3 times last year and watched her submit them, but nothing would show up and Cigna said they did not get them!  Then ASH started telling the doctors office to submit the claims to them, so they did that....Still nothing!

I wrote a very frustrated customer complaint on Facebook, and got a responce from "Ann" at letushelpu.com.  She told me she would help fix this problem!  Ya right!!   She has been no help at all.  ASH states they have "never" had any communication with the doctor's office, so I personally faxed 26 pages of documentation to her!  She seemed suprised in her responce back to me!  Like she thought I was lying to her!     

Today I logged on to Cigna's website to see that they have deined another claim on 9/23/13 as already paid!!??  Are you kidding me???  They have not paid one dime since 8/16/13!!!!  All you can really do at this point is laugh at the rediculousness!!!!  But I do know from my husband sitting on the Health & Welfare Trust in his last job that everytime ASH sends out a letter of any kind they make money!!!   That is what all this is about them making money and the patient is screwed!  I am being held accountable by this doctor's office for all unpaid bills!!!  We pay over 500.00 per month for our insurance benifits! 

I want someone at Cigna to take responcibility for this train wreck!!!  I want our bills paid!  Now we are being told that ASH will handle all claims not just after 5 visits!!  OMG   My daughter has Proven Sciatica, Proven Scoliosis, She is 5"2 with a small bone frame, and she wears a 34DDD bra size!  How could any Doctor look at her records and not understand she is in pain and needs adjustments to help her???  She did not abuse the system and go 3 times a month!  She saw him 10 times the whole year!!  We are supposed to be allowed 30 per year!!!    I am signing this * So Frustrated*