Coordination of Benefits

I had my son in January 2024 and he then had a 10 day NICU stay. I put my son on my Cigna plan. My husband has Capital Blue and we did not put my son on his plan.

Cigna paid what they were supposed to the hospital and I paid what I owed and all my accounts for the hospital currently show a $0 balance.

In May 2024 I started receiving letters for the hospital stating that Cigna is asking for a refund due to coordination of benefits saying my husband has insurance and his should be the primary payor. I called Cigna and they’re saying that he has automatic coverage for our son for the first 30 days after birth and that since his birthday is before mine that his is primary.

We then called my husband’s insurance company (2 different times) and they said that’s not a thing and they don’t provide coverage for our son unless we had enrolled him after birth.

I called Cigna back and they said they had called my husband’s insurance theirselves and they said they will cover it. Cigna says I need to call the hospital and get them to submit the claim to his insurance.

I called the hospital and told them that I needed the claim submitted to his insurance and they said they couldn’t just submit a claim to his insurance if my son has no coverage with them. After another call to Cigna they then said they called the hospital and told me I again needed to call them to submit the claim.

I call the hospital again and this time they take my husband’s Capital Blue information and will submit the claim to his insurance.

9 days pass and I get another letter from the hospital saying Cigna wants a refund. I call the hospital to see if they submitted the claim to capital blue and this lady tells me she can’t see my husband’s insurance information I provided and I need to provide it again. I give it to her and again i’m told they’ll submit the claim to them.

I’ve been so stressed since May dealing with this and making phone calls constantly. What can I do to get a resolution with this?

submitted by /u/Ok_Claim3963
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