If you do not want to or are unable to find and submit documentation of denied or reduced claims filed with CIGNA during the stated time period, you can opt to be part of a $30 million fund to be divided evenly among all the physicians who chose to participate in this category. You need to go to the Category A Proof of Claim Form at www.cignaphysiciansettlement.com/documents/G359CategoryA.pdf and return to the CIGNA settlement administrator listed at the bottom of the form.
If you don’t want to “opt out” of the mass settlement, then you need to choose to participate in one of two funds.
If your services didn’t receive customary rates from CIGNA, you should complete the Category One Compensation Proof of Claim Form at www.cignaphysiciansettlement.com/documents/G277CategoryOne.pdf and return to the CIGNA settlement administrator listed at the bottom of the form.
If your services were denied or reduced from CIGNA, you should complete the Category Two Compensation Proof of Claim Form at www.cignaphysiciansettlement.com/documents/G278CategoryTwo.pdf and return to the CIGNA settlement administrator listed at the bottom of the form.
If you were denied reimbursement from this settlement and you want to dispute the decision, you should complete the CIGNA Compliance Dispute Claim Form at http://www.ama-assn.org/ama1/pub/upload/mm/368/cignacomplianceform.pdf and return it to the CIGNA compliance dispute facilitator listed at the bottom of the form.
If CIGNA denied a claim for services that in your opinion was medically necessary, complete the Claim for Medical Necessity Denial Compensation Form at http://www.cignaphysiciansettlement.com/documents/G279MedicalNecessity.pdf and return to the CIGNA physician settlement administrator listed at the bottom of the form.
If you decide to participate in Category A, the dollar amount of your reimbursement won’t be finalized until Feb. 18, 2005 when the settlement claims period concludes. Approximately two weeks after Feb. 18, 2005, you can expect to receive payment based on the number of physicians participating in Category A.
For categories one, two and medical necessity, the reimbursement comes out of an uncapped fund where you can submit forms to the settlement administrator on a rolling basis. Upon receipt, forms will be reviewed, approved and reimbursed on a weekly basis, every Friday until Feb. 18, 2005.