Digital Claim Correspondence for Cigna
Beginning today, registered users with the Claim Search entitlement have access to digital claim correspondence via the Messaging Center on CignaforHCP.com.
HHSC: Star+Plus Webinars
HHSC is transitioning contracts for the STAR+PLUS program effective September 1, 2024.
They will be conducting webinars to assist with the STAR+PLUS transition as this change will affect both members and providers.
ONLY TWO SESSIONS LEFT
Saturday June 22nd, 9:00-10:00 AM
Monday June 24th, 1:00-2:00 PM
G-Code Frustration
Deepening ongoing physician concerns over the implementation of Medicare’s add-on code for complex care, two major payers have either reduced payment for G2211 claims or announced plans to stop paying certain claims associated with the code altogether for particular plan members.
Cigna Provider Newsroom
WEBINAR SCHEDULE FOR DIGITAL SOLUTIONS: You’re invited to join interactive, web-based demonstrations of the Cigna for Health Care Professionals website (CignaforHCP.com). Learn how to navigate the site and perform time-saving […] Read more >
CLINICAL, REIMBURSEMENT, AND ADMINISTRATIVE POLICY UPDATES: To support access to quality, cost-effective care for your patients with a medical plan administered by Cigna Healthcare, we routinely review clinical, reimbursement, and administrative […] Read more >
COORDINATION OF CARE: Coordination of care is the process by which a patient’s team of providers cooperatively help coordinate care management and ensure access to quality, cost-effective care. […] Read more >
New Option to Report Violations of the Emergency Medical Treatment and Labor Act
“Health and Human Services (HHS) is committed to protecting access to emergency medical care for everyone in America.”
“We will continue to uphold the law and the right to emergency care, to inform people of their rights under EMTALA, and to make it easier for someone denied care to file a complaint.”
For more information, please visit: https://www.cms.gov/priorities/your-patient-rights/emergency-room-rights.
UHC Responsible for Breach Notifications
The Health and Human Services (HHS) Department announced Friday (May 31, 2024), United HealthCare must take responsibility for informing people about privacy breaches resulting for the the Change Healthcare cyberattack.
UnitedHealth Group previously disclosed that the ransomware attack exposed personal information of a “substantial portion” of Americans.
That “substantial portion” turns out to be 1 in 3 Americans.
“OCR must affirm its position that the breach was perpetrated upon Change Healthcare, whose status as a healthcare clearinghouse makes them a covered entity under HIPAA and thus responsible for the breach of any [protected health information] which it processes or facilitates the processing of,”
Under HIPAA, UnitedHealth Group must provide affected individuals with descriptions of the incident, what data were compromised, how the company responded to the attack, how the company can be reached and what individuals can do to protect themselves.
Cyberattack Added to MIPS Hardship Exemption
Due to the ongoing impact of the Change Healthcare cyberattack on an increasing number of physician practices, the Centers for Medicare & Medicaid Services (CMS) has added an option to cite the cyberattack when requesting a hardship exemption within the 2024 Merit-based Incentive Payment System (MIPS).
CMS has added the option to the Extreme and Uncontrollable Circumstances (EUC) application. The 2024 MIPS EUC portal is now open, and physicians have until Dec. 31 to file a hardship application and avoid a 2026 MIPS negative payment adjustment
Avoid Medicaid Disenrollment
Physicians Must Validate Email to Avoid Medicaid Disenrollment, Payment Delays
By Emma Freer
Texas Physicians who care for Medicaid patients should confirm their email address is valid in the Texas Medicaid and Healthcare Partnership’s (TMHP’s) Provider Enrollment Management System (PEMS) to ensure effective communication and timely payments from the state Medicaid administrator.
Without a valid email address on file in PEMS, clinicians will not receive online correspondence from TMHP, including reminders regarding their upcoming revalidation due dates, or be able to start a revalidation request, among other consequences.
Clinicians who fail to complete their respective revalidations by their given due dates will be disenrolled from Medicaid.
For step-by-step instructions on how to add and verify your email address in PEMS, check out TMHP’s handout.
TMHP also encourages clinicians to add the “TMHP.com” domain to their safe senders list in their email system and to avoid unsubscribing from TMHP emails.
For more information, reach out to TMHP via email or by calling (800) 925-9126.
Physician Directory and Provider Roster Update
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