Cigna’s Computer Systems Still Dysfunctional

Almost four months after the US Government’s Center for Medicare and Medicaid Services (CMS) banned Cigna from advertising its Medicare Advantage plans and from signing up new Medicare beneficiaries, things do not seem to have improved. CMS conducted an audit of Cigna’s operations in October 2015 and “concluded that Cigna substantially failed to comply with CMS requirements regarding Part C [medical coverage] and Part D [drug coverage] organization/coverage determinations, appeals and grievances.” CMS also wrote that “Cigna has had a longstanding history of non-compliance with CMS requirements.” It called Cigna’s “organizational structure…decentralized and fragmented.”

I have seen no sign that this fragmentation has been corrected. I am a Cigna HealthSpring enrollee in Arizona, and dealing with Cigna’s various computer systems is a nightmare. Before, I get into details, I want to stress that I have no complaints about the medical services I have received. I have confidence in my doctors. However, being healthy I have used few services other than routine physical examinations and cataract surgery.

I was in a Cigna pharmacy two days ago to pick up a prescription, and the woman who waited on me asked for a list of my non-prescription drugs. I told her that I take two vitamins and said that they were already in the Cigna computer system. “Yes,” she replied, “but we have no access to the information that is in the doctors’ computers. We have our own system.”

I blogged earlier about the trouble I had getting a Cigna card for 2016. I repeatedly called customer service, and customer serviceĀ  told me each time that they had entered the information into the computer that would send me a card. No card arrived. Customer service was simply unable to get the computer to do what it was supposed to do. I finally was able to contact someone who was able to bypass the problem and get me a card, months after I should have received it.

I am supposed to be able to access my insurance information on the website, but when I log in, that system tells me that I have drug coverage only. Not true! I also have Medicare insurance with Cigna. When I click on the button to download my proof of coverage, a document pops up showing my 2015 coverage. There is nothing on the site that indicates that I have Medicare insurance with Cigna for the year 2016, but I do. The MyCigna app on my cell phone will not recognize my login credentials at all.

I am supposed to access my medial records on another Website, That site is also only partially functional. The records that my primary care physician uploads are there. The records from specialists are not. The site is also supposed to display my upcoming appointments. There is a note showing that I have an appointment next Wednesday for a follow-up on the cataract surgery to my second eye. What about the surgery itself? There is no indication on the site that I have outpatient surgery scheduled on Tuesday. If I were to follow my calendar of medical appointments on the Follow My Health calendar, I would be there for my follow up visit, but I would miss the surgery itself.

There are also several other websites, some of which I have been referred to by various people working in customer service. I cannot establish an account on any of them. They simply do not recognize me as a Cigna enrollee.

If you are thinking of signing up for a Cigna Medicare Advantage plan, I do not have to warn you away. The US government will not allow you to make that mistake. The big question is, will Cigna be able to solve its problems by the beginning of the open enrollment period at the end of the year? So far, that does not look very promising. If Cigna does not solve its many problems, will those of us currently covered by a Cigna Medicare Advantage plan be allowed to renew, or will the federal government simply shut down Cigna’s dysfunctional Medicare Advantage plans permanently? No seems to know the answer. I am certainly prepared to switch Medicare Advantage plans next year.

In the meantime, Cigna’s planned merger with Anthem is reported to still be on track. Anthem has had its own problems with its insurance plans. When two dysfunctional companies are permitted to merge with each other, the result is usually dysfunction multiplied. I wish some government agency would have the good sense to step forward and block this merger.