Tag: Cigna Healthcare (MA), Also see HealthSpring (HCSC)
Cigna MA Stars 101 Webinar
NEED A REFRESHER
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Cigna MA
Overview of the Stars Program
Cigna’s West Region Stars Team will provide an overview of the Stars Program and available reporting and resources:
- What is the Star Rating and why is it important
- Components of the Star Rating
- A review of available reporting related to Stars
- Tools and Resources available for your office
Event Number: 179 385 5641
Event Password: stars
June 9th, 1:30 CST
TWO New Measures for Part C Stars
The Part C Stars Specification Overview has been updated for 2022 Dates of Service.
It includes two new measures –
- Follow-Up After Emergency Dept Visit for People with Multiple High-Risk Chronic Conditions (FMC)
- and Transition of Care (TRC).
Cigna Continues CoVid Accommodations
Over-the-counter testing
Consistent with new federal guidelines for private insurers, Cigna commercial will cover up to eight over-the-counter (OTC) diagnostic COVID-19 tests per month (per enrolled individual) with no out-of-pocket costs for the tests. This coverage began January 15, 2022 and continues through the end of the PHE (currently through April 15, 2022).
Please note that while Cigna Medicare Advantage plans do fully cover the costs for COVID-19 tests performed in a clinical setting, costs of at-home COVID-19 tests are not a covered benefit at this time.
Additionally, we encourage you to remind your patients that the Federal Government is now offering four free at-home test kits per household with no cost. Your patients can order the free at-home COVID-19 testing kits at COVIDtests.gov.
Coverage of COVID-19 treatments
As a reminder, Cigna commercial and Cigna Medicare Advantage cover FDA emergency use authorized (EUA) treatments of COVID-19, including monoclonal antibody treatments. This includes new antiviral medications PaxlovidTM and molnupiravir, as well as Remdesivir infusions when administered in an inpatient or outpatient setting.
Get all the most up-to-date information
We updated our dedicated COVID-19 provider web page on January 21, 2022 to highlight these updates more. You can also access the latest Cigna Medicare Advantage billing guidelines from this page. Please visit the site often to get the latest information.
POET Is Seeing a Trend, UPDATE
On January 5th, Sir Seymore posted on Ink that POET is seeing a trend from Physician Offices that are trying to get a referral from Cigna MA.
Please scroll down to review that post for details.
POET received this information from Cigna MA: “Unfortunately, we’re experiencing a known enterprise-wide issue within the MHK/HSConnect platform that is affecting how many of our participating specialists are reflecting in the dropdown box or search box when attempting to generate a referral. The MHK/HSConnect team is working towards remediation but I have not yet heard when the expected date for completion might be.”
Just a reminder: SCPs do not need a referral due to the Public Health Emergency (PHE). The PHE has been extended until April 16, 2022.
PCPs and SCPs you are welcome to confirm participation with POET or Leslie.
Per Cigna MA, you should be able to manually enter the specialists’ (SCP) name/NPI for a referral.
The First Quarter 2022 issue of Cigna Network News is now available
Check out these pages:
4. Preventive Care Services Policy Updates
5. Reimbursement Policy Updates
7. Precert Updates (click here to view the Master Precert List)
8. Webinar Schedule for staff training.
18. 2022 Cigna MA plan highlights (and card sample)
25. How to use Z Codes
34. How to contact Cigna
CIGNA MA Information Update from POET
POET has received a few calls regarding the Cigna MA PPO plan that came into effect January 1, 2022.
- To the left is a screen shot of one PPO product’s card. (I’m sorry it is not to pretty.)
- No PCP is required.
- Referrals are not required
- Providers are still responsible for receiving PRIOR AUTHORIZATION.
You may have noticed the Cigna MA insurance card no longer sports the “HealthSpring” Logo.
The below list are for Provider use only. Not to be distributed to Patients
HMO Customer Benefit Plans for Our Service Area
PPO Customer Benefit Plans for Our Service Area
- Cigna Preferred Medicare HMO
- H4513-061-001
- CignaTotalCare HMO D-SNP
H4513-060-001 - Cigna Fundamental Medicare HMO H4513-009-000
- Cigna Preferred Savings Medicare HMO
H4513-066-000
- Cigna True Choice Medicare PPO
H7849-038-000 - Cigna True Choice Plus Medicare PPO
H7849-062-000
POET Is Seeing a Trend
Please contact POET if you are experiencing a similar problem. (936) 637-7638
POET has received a few calls this week from Specialists (SCP) stating that Primary Care Physicians (PCP) have not been able to get the SCP a referral. The PCP office is stating Cigna MA is showing the SCP out of network.
- POET has been in contact with Cigna MA regarding the situation. Cigna will be reviewing to see if there is a greater problem.
- So far it appears to only be effecting SCPs in the HMO product.
- Just a reminder: SCPs do not need a referral due to the Public Health Emergency (PHE). The PHE is scheduled to lapse on January 16, 2022. POET has been on the Public Health Emergency website and the U.S. Department of Health & Human Services website to look for new information on the PHE lapse date. We have nothing to report as of this post.
OOPS!! Cigna MA Letter ERROR
Apparently a letter went out to some Cigna members that was supposed to be alerting them that the contract with the CHS hospital (WHMC) is being terminated. There was an error in the letter because it stated “Your doctor is leaving the network”. This has caused a flurry of concern and confusion in some areas, as you might imagine. A corrected letter, further clarifying that the entity being terminated is the hospital and not the physician, is expected to go out Oct. 5th.
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