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Diagnostic Imaging Denial

Cigna Denied Your MRI Scan?

Published data shows denial and appeal outcomes vary by plan, product year, denial reason, and documentation. Use this page to spot the issues to request and the evidence to gather before you decide what to submit.Sources include KFF ACA Marketplace Transparency Data, HHS OIG reports, and state insurance department filings. Aggregate rates are context, not predictions for an individual case.

Varies
Denial Data
Case-specific
Appeal Outcome
30-60 days
Typical Timeline
$1,200–$5,000
Typical Claim

Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.

Why they said no

Why Cigna Denies MRI Scan

Prior authorization required but not obtained

Deemed not medically necessary at this stage

Lower-cost imaging (X-ray, CT) not tried first

Cigna patterns

Cigna's Common Denial Patterns

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

What works

How to Strengthen Your MRI Scan Appeal

Clinical notes explaining why MRI is specifically needed over other imaging

Documentation of symptoms warranting urgent imaging

Peer-to-peer review between ordering physician and insurer medical director

Your rights

Laws That Protect You

ACA §2719 — Right to appeal imaging denials

No Surprises Act — Protection against balance billing

State laws requiring timely authorization decisions

Playbook

Tips for Appealing to Cigna

Reference the documented pattern of high-speed automated denial review and request proof of individualized physician review

Gather evidence of prior failed treatments to counter step therapy requirements

Obtain peer-reviewed studies supporting FDA-approved treatments

Ready to Review Your MRI Scan Denial?

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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.