Cigna question

I don’t know if anyone here can help me.

I’ve had some ongoing GERD issues for a few years, and it’s not controlled by (2!) medications. My PCP, who I have seen for 13 years, ordered an upper GI endoscopy.

I had a list of places to call to have the test done. Called the first one.

When I tried to make an appointment for the endoscopy, I was told “your insurance requires an in person appointment before we can book that.”

Okay, that felt weird, but fine. I took half a day off of work for the first appointment they could get me in for.

Get to the appointment, and it was a 5 minute conversation with a PA. She said “yup, you need an endoscopy.”

I said I knew that, and I asked what the point of the appointment was for- and I believe this is when she gave it away. She said “oh, we just like to write the referrals to make sure they are approved.”

Ex-fucking-scuse me?! I took a half a day off of work, and it’s a $60 copay, for that 5 minute conversation with a PA that was their preference, not required by my insurance?”

I can’t find anything in my EOB or other insurance paperwork that backs up the initial claim that it was “required by Cigna.”

Between the lost hours at work and the copay, I genuinely can’t afford to have the test done. They also won’t let me have the test until I schedule a follow up with their office.

I just want the damn test. I didn’t research their physicians. I chose them bc it was a convenient location, but they seem to want me to be a patient of their practice, and I’m not sure I need to be yet.

So my question is this- is there anyone familiar with Cigna that can confirm it was required? Would I be out of pocket to ask them to provide me with proof that it was a requirement of the insurance company? Can I contest the charge if they can’t provide that?

Because everything I’m seeing says that the referral from my primary care doctor should have been fine. This feels like really deceitful practices and I don’t even know that I trust them with my care at all this point.

submitted by /u/ClickClackTipTap
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