Guest dfwalter Posted June 11, 2004 Posted June 11, 2004 :angry:I am looking for information regarding questionable practioners who are in this plan and whether CIGNA does anything to screen the providers that are in the network. My information is that the CIGNA DMO is about to be the Defendant in a suit in NJ and Federal Court along with the PEO Extensis because they do not screen their providers, respond to customer complaints or enforce the network contracts when things go wrong. If anyone has the information I need before I review the RFP please respond.
GBurns Posted June 11, 2004 Posted June 11, 2004 I assume you meant that CIGNA would be the Defendant in the suit. I think that your best sources would be the Plaintiff who is filing the suit and the NJ Dept of Insurance investigators and Market Conduct people who would have the record of complaints etc. If you are about to review the RFP, while these questions are being asked, I have to question the thoroughness of the RFP. Why did it not ask for disclosure of any lawsuits etc? Why did it not ask for info on Provider credentialling and monitoring? Have you looked at their Schedule F (Resisted and Disputed Claims) that they have filed with the Dept of Insurance? George D. Burns Cost Reduction Strategies Burns and Associates, Inc www.costreductionstrategies.com(under construction) www.employeebenefitsstrategies.com(under construction)
Guest dfwalter Posted June 11, 2004 Posted June 11, 2004 You are correct. I meant Defendants. Any suggestions about disseminating this information to the consulting community would be helpful.
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