Cavalier40
Guest
I am wondering if there is any guidance out there on how to get Cigna to disclose their audit results to us. We have had a flag placed on our TIN since mid April, but the auditor just will not respond via phone or email and we have no idea what they found, especially what would be so wrong that a flag was placed....especially since we just went through an Optum BH audit of the same time period and they found 0 problems, not even a nitpick that would have resulted in a $1000 overpayment.
I know Cigna has been punitive with their audits. I have dealt with them with other facilities I have worked with, however I have never been stonewalled like this before. My SOP has always been to establish communication with the auditor and address problems one by one. I cannot do that now because the auditor will either not communicate with me, or in the rare instance she sends an email, she will not give any information. Is any one else going through this now that might have insight? Should I get my legal team to intervene now? (I was hesitant to get legal involved prior to reviewing the results since it may bypass the appeal and move strait to overpayment negotiation....which I believe there shouldn't even be an overpayment)
Any guidance would help me greatly.
I know Cigna has been punitive with their audits. I have dealt with them with other facilities I have worked with, however I have never been stonewalled like this before. My SOP has always been to establish communication with the auditor and address problems one by one. I cannot do that now because the auditor will either not communicate with me, or in the rare instance she sends an email, she will not give any information. Is any one else going through this now that might have insight? Should I get my legal team to intervene now? (I was hesitant to get legal involved prior to reviewing the results since it may bypass the appeal and move strait to overpayment negotiation....which I believe there shouldn't even be an overpayment)
Any guidance would help me greatly.