Kessler Topaz is currently investigating claims against Cigna on behalf of its current and former insureds for potential violations of state law and/or federal laws. Our investigation is focused on Cigna’s use of an algorithm called “PXDX” which Cigna uses to “review” and deny claims. This system automatically turns down payment for a treatment that doesn’t match one of the conditions on the PXDX list. Denials are then sent to medical directors, who reject these claims with no review of the patient file. Company doctors then sign off on the denials in batches with an electronic signature. For example, according to a recent news report, one Cigna doctor rejected 121,000 claims in the first two months of 2022. Moreover. Cigna carefully tracks how many patient claims its medical directors handle each month. Twelve times a year, medical directors receive a scorecard in the form of a spreadsheet that shows just how fast they have cleared PXDX cases.
Please contact us today to discuss your rights if you are a current or former Cigna insured. You may contact us at 484-270-1453, or you can fill out our online form below, or by email at info@ktmc.com.