July 2022 – POET LLC

Cigna Medicare HSConnect Portal

Cigna MA has reported two known issues with HSConnect.

Referrals are pending unnecessarily.
The procedure start and end date are defaulting to the same day.

An expected date for resolution has not been provided.

But there is good news (tongue in cheek) the PHE has been extended. Therefore, referrals are still waived. Those items requiring precertification will continue to need an authorization.

PHE Extended

July 15th, Secretary of Health and Human Services, Xavier Becerra renewed the determination that a public health emergency exists. This will add another 90 days, extending the PHE through October 13, 2022

POET has been asked:

Where is the best place to order Approved 1500 Forms (Better known as HCFA of HICF)?

Please leave a comment below. Thank you.

Updates for Your Front Desk

Do you have the latest information at your finger tips?

Just for you!

No Surprise Act:

Share information with your patients to help protect them from surprise billing.

As of January 1, 2022, they have new billing protections under the “No Surprise Act” when they receive:

Emergency care
Non-emergency care from out-of-network providers at in-network facilities
Air ambulance services from out-of-network providers

Just click the links below for printable information.

Sick of Chart Review Request?

If you are frequently being ask by Cigna MA for chart reviews, click the button below to find out how to reduce the number of requests you receive.

UHC Policy and Protocol Updates

AMA unveils anticipated E/M changes for facility-based services

The AMA set off its own fireworks during the Independence Day weekend with the early release of new E/M guidelines that will be included in the 2023 CPT manual and take effect Jan. 1, 2023

Beginning on that date, the format for office and other outpatient visits (99202-99215) will apply to hospital inpatient and observation visits, consults, and services in the emergency department, nursing facility, home and residence. As a result, history and physical examination will no longer contribute to the level for these visits. Instead, for most visits practices will select codes based on medical decision-making (MDM) or time. The only exception will be emergency department visits, which will be MDM-only because the codes do not have a time component.

Among the most radical changes, the AMA plans to delete all observation care codes (99217-99220, 99224-99226) and merge observation services with initial and subsequent hospital care codes (99221-99223, 99231-99233, and 99238-99239)

Cigna Delays Record Request Policy

You may have read the article posted May 23rd. Cigna (Commercial) had implemented a new policy that required medical records be sent when a minor procedure is billed with an office visit.

However, Cigna has delayed the Records Request Policy, Staving Off the “Administrative Nightmare” for now.

Cigna has delayed the implementation of a new billing policy after the Texas Medical Association and others in organized medicine pushed back, warning that it would have negative implications for physicians, practice staff, and patients.

Month: July 2022