If your office has an issue with the payment of a claim, the first step is to contact CIGNA's Customer Service Center and attempt to resolve the issue. If you and the customer service rep agree that the claim needs to be reviewed, the claim will be forwarded to the appropriate area for review.

If you don't agree with the CIGNA determination and wish to appeal, document your concern in writing and send it to this address along with a copy of the Explanation of Benefits (EOB) statement:

CIGNA Dental
PO Box 188044
Chattanooga, TN 37422-8044

An appeal is a request for the review and/or reconsideration of:

  • An adverse plan determination of all or part of a pre-service request for provision of health care services or benefits
  • Denial of payment of a claim for service that has already been performed

When sending an appeal to CIGNA, be sure to include copies of any documentation (EOB, documentation of benefit coverage, office notes, operative report, etc.) with your appeal letter, and label the letter "APPEAL" at the top.

  • Have the member's SSN or alternate ID number when you call CIGNA Dental's Customer Service Center
  • Have the EOB with the member's name, date of service and amount of charge.
  • Always get the name of the Customer Service Representative you spoke with on the phone, and note the date and time of call.
If your office notices a pattern of claims that appear to be processed incorrectly, contact Caterpillar's Provider Relations team immediately.