I’m dealing with a frustrating situation involving my son’s medical claim for a sleep study. The claim was denied by Allied Benefit (Cigna’s TPA) as “not medically necessary,” which is incorrect as the sleep study was recommended by his physician and deemed necessary for medical purposes.

The doctor’s office is currently working on an appeal, but Allied Benefit told me that the review could take up to 120 days. The worst part is that I’ve been asked to pay about $4,000 upfront or face collection, which feels like I’m being penalized for a mistake on their end.

I’m frustrated that Cigna is essentially hiding behind Allied Benefit, with little accountability, and I’m unsure how to proceed. Has anyone had similar experiences? How did you escalate the issue or file a complaint, especially when the insurance card only references the third-party administrator? Any advice or suggestions would be greatly appreciated.