Cigna Denied Your Lab Work / Diagnostic Testing?
According to federal data, Cigna Healthcare (The Cigna Group) denies approximately 18.5% of claims. When patients appeal, about 52% are overturned. Your lab work / diagnostic testing denial may have grounds for a successful appeal.Sources: KFF ACA Marketplace Transparency Data, HHS OIG Reports, state insurance department filings. Rates are aggregate averages — individual results vary by plan type, denial reason, and documentation.
Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.
Why Cigna Denies Lab Work / Diagnostic Testing
Test not indicated based on diagnosis code
Duplicate testing within coverage period
Experimental or investigational test classification
Cigna's Common Denial Tactics
Mass auto-denials (300,000 claims in 2 months at 1.2 seconds each)
Requiring step therapy for medications your doctor already tried
Denying claims as "experimental" despite FDA approval
How to Win Your Lab Work / Diagnostic Testing Appeal
Physician order with specific clinical indication
Evidence test results changed treatment plan
Published clinical guidelines recommending the test for the diagnosis
Laws That Protect You
ACA — Preventive services coverage
CLIA standards for laboratory testing
State genetic testing protection laws
Tips for Appealing to Cigna
Reference the ProPublica investigation into automated denials
Gather evidence of prior failed treatments to counter step therapy requirements
Obtain peer-reviewed studies supporting FDA-approved treatments
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This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.