--- title: "Cigna denial rate: none in the 2027 file, your dates" url: "https://denialfacts.com/company/cigna" publisher: "Axion Labs — Denial Facts" checked: "2026-11-04" dataset_fixity: "sha256-cda2f9b89c8dde2a74989a35dbe7c0d08ff35dac5456484dc1c03c1b181a67b6" --- # Cigna denial rate: none in the 2027 file. Here is how the appeal works, and your 180-day deadline. Your Cigna denial appeal: Cigna's steps, quoted and dated, and your 180-day and 4-month deadlines from your notice, free. ## Cigna, at the top of the page Cigna, the appeal process Your two dates, free Date on your denial notice Who pays your claims? A job, an insurance company pays the claims A job, my employer pays the claims itself (self-funded) A job, I do not know which Marketplace / individual plan I bought myself Medicare, Medicaid, TRICARE, VA or IHS Which state? The reason your letter gives I'm not sure, I'll paste the sentence later Not medically necessary Provider out of network Service excluded from the plan Experimental or investigational Referral required Benefit limit reached Member not covered Administrative reason Other reasons Show my two dates, free Put in the date on your Cigna notice and get both federal deadlines as calendar dates. Free, for a Cigna denial, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored. That date runs from the day printed on the notice, not the day you opened it, and if your employer pays the claims itself, your external review does not go to your state at all. We checked Cigna's appeal steps against its own pages on November 5, 2026. We quote them below. Neither page gives you your due date. The 180 days run from the date on your notice. Cigna Claim denied because of billing. Out of network We hear this most. [r/HealthInsurance, thread title](https://www.reddit.com/r/HealthInsurance/comments/1tp86tc/cigna_claim_denied_because_of_billing_out_of/) , read September 3, 2026. By [Axion Labs](/about) · August 19, 2026, updated November 4, 2026 No current Cigna denial rate in the 2027 file. The current [CMS Transparency in Coverage file](https://data.healthcare.gov/) , the plan-year 2027 release issued October 22, 2026 and read November 4, 2026, carries no Cigna reporting entity, so this page prints no Cigna denial rate. The clock your letter has to describe, in actual dates If Cigna denied a claim of yours, two dates matter more than any percentage. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours . Both timeframes are federal, not your insurer's choice, [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-2560.503-1) ( [PDF](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) ) and [45 CFR 147.136](https://www.ecfr.gov/current/title-45/section-147.136) ( [PDF](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) ), in plain English at [HealthCare.gov](https://www.healthcare.gov/appeal-insurance-company-decision/internal-appeals/) , and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can. Data verified November 4, 2026 · CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain You are not alone, measured rather than said: 83,907,852 in-network claims were denied in a single plan year, and only 4,918 of them, one in 17,061, ever reached the independent review stage. Of the ones that did, 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) were overturned. What to do tonight - Find the reason code on your denial letter. The notice has to state the specific reason and the plan provision behind it. Copy the code and the wording onto a piece of paper tonight, that sentence is what your appeal has to answer. - Ask Cigna for the clinical criteria they judged you against. Under [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-2560.503-1) they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read. - Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. Nationally only 1 in 17,061 denials ever reaches the second stage, and that is a deadline problem far more often than an argument problem. None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes. ## How Cigna says an appeal works, in its own words We read both sources and quote each line as written. Each is labeled provider or member. The provider source's decision clock is never the member's clock. Member clocks differ by plan design. Your plan brochure or Summary Plan Description sets yours. ##### Who files which dispute Cigna's own table of which denial scenarios are appealed by the CUSTOMER (the patient) and which by the HEALTH CARE PROVIDER. The split is easy to miss, and appealing a denial that only your provider has standing to appeal wastes the window. | Dispute (Cigna's wording) | Route | | --- | --- | | Precertification (authorization) denial (for services not yet rendered) | Customer appeal | | Precertification (authorization) not obtained – services denied | Health care provider appeal | | Claim reimbursement denial (including mutually exclusive, incidental, or bundling denials, and modifier reimbursements) | Health care provider appeal | | Experimental or investigational procedure denial | Either | | Benefit denials (e.g., exclusion, limitation, administration [e.g., copay, deductible, etc.]) | Customer appeal | | Maximum reimbursable amount | Customer appeal | | Inpatient facility denial (e.g., level of care, length of stay, delayed treatment day) | Either | | Medical necessity denial | Either | Provider process: from [Appeals and Disputes Policy and Procedures](https://www.cigna.com/health-care-providers/coverage-and-claims/appeals-disputes) , checked November 5, 2026. ##### The steps and the clocks, quoted - Provider process. Provider appeal filing window: 180 calendar days. “within 180 calendar days of the date of the initial payment or denial notice” Note: Provider-side window. The member's own internal-appeal right is at least 180 days under federal law (29 CFR 2560.503-1(h)(3)(i)) independently of this policy. From [Appeals and Disputes Policy and Procedures](https://www.cigna.com/health-care-providers/coverage-and-claims/appeals-disputes) , checked November 5, 2026. - Provider process. Arbitration as final step, provider disputes: within one year of the final internal decision letter. “you must request arbitration within one year of the date of the letter communicating the final internal level review decision” Note: Applies to provider payment/termination disputes, not to a member's external review right. From [Appeals and Disputes Policy and Procedures](https://www.cigna.com/health-care-providers/coverage-and-claims/appeals-disputes) , checked November 5, 2026. - Provider process. Reconsideration route for coding-edit denials: CignaforHCP.com or Provider.Evernorth.com. “a CignaforHCP.com or Provider.Evernorth.com user with claims/reconsideration access can submit a reconsideration request on the claim” Note: Provider portal route — a patient cannot use it, but can ask their provider's billing office to. From [Appeals and Disputes Policy and Procedures](https://www.cigna.com/health-care-providers/coverage-and-claims/appeals-disputes) , checked November 5, 2026. - Provider process. Appeal mailing addresses vary by ID-card indicator: GWH-Cigna/'G' cards: PO Box 188062, Chattanooga, TN 37422 · all other appeals: PO Box 188011, Chattanooga, TN 37422. “If the ID card includes the “GWH-Cigna” or “G” indicators: Cigna Healthcare Inc. National Appeals Unit (NAO) PO Box 188062 Chattanooga, TN 37422 … For all other appeals: Cigna Healthcare Inc. National Appeals Unit (NAO) PO Box 188011 Chattanooga, TN 37422” Note: The ID card decides the address. Sending an appeal to the wrong PO box costs days inside a fixed window. From [Appeals and Disputes Policy and Procedures](https://www.cigna.com/health-care-providers/coverage-and-claims/appeals-disputes) , checked November 5, 2026. - Member process. Member appeal filing window: 180 calendar days. “within 180 calendar days of the date of the initial payment or denial notice” Note: Member-side confirmation: same 180-day window Cigna publishes on the provider side, here stated to members. File by phone (number on the ID card) or via the myCigna Forms Center. From [Health Care Appeals & Grievances (member guide, undated page)](https://www.cigna.com/individuals-families/member-guide/appeals-grievances) , checked November 5, 2026. - Member process. Member appeal decision clocks: 30 days medical-necessity appeals / 60 days post-service administrative. “within 30 calendar days for Pre Service and Post Service Medical Necessity appeals, and within 60 days for Post Service Administrative appeals” From [Health Care Appeals & Grievances (member guide, undated page)](https://www.cigna.com/individuals-families/member-guide/appeals-grievances) , checked November 5, 2026. - Member process. External review is binding on Cigna: independent external reviewer, medical-judgment appeals. “you or your representative may have the option to submit the dispute for resolution (which is binding upon Cigna Healthcare and the plan) by an independent external reviewer for appeals that involve medical judgment” Note: Availability depends on plan type — self-insured employer plans may not offer it. From [Health Care Appeals & Grievances (member guide, undated page)](https://www.cigna.com/individuals-families/member-guide/appeals-grievances) , checked November 5, 2026. Sources: Cigna, [Appeals and Disputes Policy and Procedures](https://www.cigna.com/health-care-providers/coverage-and-claims/appeals-disputes) , on www.cigna.com, written for health care providers, checked November 5, 2026. Cigna, [Health Care Appeals & Grievances (member guide, undated page)](https://www.cigna.com/individuals-families/member-guide/appeals-grievances) , on www.cigna.com, written for members, checked November 5, 2026. ## Your two dates The [free deadline calculator](/appeal-deadline-calculator) turns your Cigna notice date into a 180-day date and a 4-month date. Both are federal clocks. If your plan gives more than 180 days, your letter is the authority. Two dates decide more of this than anything else, and neither is on the front of your letter in a way anyone notices. Work them out tonight, write them on the letter itself, and you have already done the part that is easiest to lose. If your dates are strange, a denial that arrived after the treatment, or a letter with no external-review instructions on it at all, send us the wording with the identifying details removed and we will tell you which clock you are on. Axion Labs · hello@getaxionlabs.com [Show my two dates, free](/appeal-letter) No account, no email, no card. Both federal deadlines dated from your notice, and the body that decides your case at the end. Where these numbers come from We read every Cigna line here on the 2 pages named above. None of them is a figure from the file below. Counts: [CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain](https://data.healthcare.gov/) . Rights and timeframes: [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-2560.503-1) (180 days, and your free right to the claim file) and [45 CFR 147.136](https://www.ecfr.gov/current/title-45/section-147.136) (4 months, and what qualifies), explained at [HealthCare.gov](https://www.healthcare.gov/appeal-insurance-company-decision/external-review/) . Expedited review is decided in about 72 hours under both sections. Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at [govinfo.gov (29 CFR 2560.503-1)](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) and [govinfo.gov (45 CFR 147.136)](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) . This page presents federal statistics and a general description of appeal rights created by federal law. It is not legal, medical, or insurance advice, and no outcome is guaranteed. Your denial letter and plan documents govern your specific case. Free help is available from your state's Consumer Assistance Program and from the federal Marketplace at HealthCare.gov. Problem solved: You have Cigna's process, labeled provider or member, and the 180-day date your appeal runs on. ## The pages that answer the next question - [If your employer pays the claims itself](/self-funded-denial) , then Cigna is only administering the plan, your state's external review has no power over the denial, and the route is federal. It is the first question our own calculator asks. - [If it was refused before the treatment](/prior-authorization-denied) , a prior-authorization refusal from Cigna runs on the same two federal clocks as a denied claim, and it can be appealed while the treatment is still ahead of you. - [Denial code CO-50 on the remittance](/denial-codes/co-50) , "not deemed a medical necessity" is the single most common category in the federal file, and it is the one Cigna has to show you the written criteria for. - [Before you pay a lawyer](/before-you-call-a-lawyer) , two free appeals run before anyone bills you by the hour, and Cigna has to hand you the claim file for nothing under 29 CFR 2560.503-1. - [All national brands ranked](/denial-rates-by-company) , the brands the current file carries enough volume to rank; Cigna is not among them. - [How both appeals work](/how-to-appeal) , the internal appeal, then the independent review whose decision binds the plan. Your dates are ready. [Write the letter, free](/appeal-letter) ## The two federal clocks The clock your letter has to describe, in actual dates Whatever else is on the page, these two dates are the page. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours . Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 ( PDF ) and 45 CFR 147.136 ( PDF ), in plain English at HealthCare.gov , and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can. ## What is free here, and what the one paid thing costs Denied a claim? Insurers upheld 165,863 of the 262,982 internal appeals counted in 2024, 63.1% ( KFF ). The win is at independent external review, and the only way to arrive there is to run the internal stage on time, in the right order, with the record intact. That sequence is what the Appeal Kit is. Get my Appeal Kit, $29 One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com. Get my Appeal Kit, $29 Everything you need for your appeal: your two deadlines, the argument that fits your denial reason, the letters, a brief for your doctor on what the reviewer checks, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com. ## What we will not pretend What we will not pretend. We cannot overturn your denial. Only your plan, or an independent reviewer, can do that. We cannot make your plan cover a service it genuinely excludes. We cannot guarantee external review applies to your denial. It covers medical judgment, experimental or investigational determinations, and rescission, a purely administrative denial may not qualify, and we say so on those pages rather than selling you past it. We have no customer testimonials and publish none. Our evidence is the federal dataset and the regulation cites, both of which you can check. ## Every page on this site Home Start here Insurers By company States Denial reasons Use cases How to appeal Ranked by denial rate The external-review gap Write the letter, free Deadline calculator Self-funded plan? Prior authorization denied Medicare WISeR denial Denial code CO-50 Before you call a lawyer Attorney for a denied claim Your denial letter United Healthcare denying claims Time limits on a claim Appeal a Medicare denial About Editorial policy How we compare Privacy Terms For machines: llms.txt openapi.json changes.json the composed answer this page as markdown ## Which release these figures are Which release these figures are Every number on this page is the plan-year 2027 Transparency in Coverage file, issued October 22, 2026, covering plan-year 2025 claims. This is the newest plan year CMS has published: there is no Transparency in Coverage file for a plan year after 2027. The dataset list is at data.healthcare.gov . A test in this site’s build fetches that list on every run and fails if CMS publishes a plan year we have not acknowledged here. Every earlier release, plan-year 2024, plan-year 2025, plan-year 2026, is kept alongside it so the record is visible rather than a single year’s snapshot; /about says what changed between them. From the plan-year 2024 release to the plan-year 2026 release, external reviews filed went from 2,336 to 5,881. Overturned reviews went from 32.8% in the plan-year 2026 release to 22.2% in plan-year 2027, or from 32.6% to 32.6% without SelectHealth. We do not compare filed or overturned counts across plan-years 2026 and 2027. Some issuers may have counted pre-service appeals in their 2026 cells. ## Where these numbers come from Where these numbers come from Counts: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain . Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov . Expedited review is decided in about 72 hours under both sections. Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136) . ## Who publishes this Denial Facts publishes federal data about health insurance claim denials. We are independent: not affiliated with, endorsed by, or acting for any insurer, government agency, or review organization. We are not a law firm, a medical provider, or an insurance producer, and nothing here is legal, medical, or insurance advice. Data: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain. Figures cover individual-market Qualified Health Plans on the federal Exchange and come from the plan-year 2027 release, issued October 22, 2026, covering plan-year 2025 claims. This is the newest plan year CMS has published: there is no Transparency in Coverage file for a plan year after 2027. See where the data comes from . ## Sources - Appeals and Disputes Policy and Procedures (checked 2026-11-05): https://www.cigna.com/health-care-providers/coverage-and-claims/appeals-disputes - Health Care Appeals & Grievances (member guide, undated page) (checked 2026-11-05): https://www.cigna.com/individuals-families/member-guide/appeals-grievances - CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain: https://data.healthcare.gov/ - 29 CFR 2560.503-1 (180 days, and your free right to the claim file): https://www.ecfr.gov/current/title-29/section-2560.503-1 - 45 CFR 147.136 (4 months, and what qualifies): https://www.ecfr.gov/current/title-45/section-147.136 - HealthCare.gov on external review: https://www.healthcare.gov/appeal-insurance-company-decision/external-review/ Cite: Axion Labs — Denial Facts, "Cigna denial rate: none in the 2027 file, your dates", https://denialfacts.com/company/cigna (checked 2026-11-04). free to quote with the URL.