Details
- Category
- Vendor
- Cigna Appeals
- Date
- Mar 10, 2023
- Processed
- Sep 13, 2026 1:10 AM EDT
- Original File
- 20230310 Cigna authorization03102023.pdf
Summary
Authorization for Release of Confidential Information for Appeal Review for member Johan Jongsma (ID 10712074603, SR# 1457315794), signed 10th March 2023 by Sophia Jongsma, authorizing John Shamblin/Tanya Smith to disclose air and ground ambulance transport records from 6/28/2022 to Cigna Appeals for the claims/appeals process.
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