A lawsuit filed March 25 claims that Cigna failed to reimburse claims for medically necessary chiropractic and physical therapy treatments.
The plaintiff is Advanced Physical Medicine of Yorkville (Ill.), which submitted approval to Cigna for 27 chiropractic and 27 physical therapy services for a patient.
The suit filed in the U.S. District Court for the Northern District of Illinois Eastern Division claims Cigna approved 18 chiropractic visits and 18 physician therapy visits but denied coverage for the remaining. Cigna cited the need to see the patient's response to initial treatments before covering more since their condition was chronic.
Advanced Physical Medicine said it submitted three rounds of appeals in total that were all denied by Cigna, which said the treatments were not medically necessary and "the patient's medical records do not include objective measurements of improvement."
The plaintiff is seeking full recovery of its claim for $18,975.77 and recovery of statutory penalties.