Tag: Cigna Healthcare (MA), Also see HealthSpring (HCSC)
Step Therapy Requirement
Cigna Medicare Advantatge
The goal of step therapy is to help achieve lower drug prices while maintaining access to drugs for patients.
Certain Part B drugs that currently require precertification will also require step therapy.
The list of drugs that require step therapy can change throughout the plan year.
Cigna Updates
Cigna is pleased to announce we are expanding our Musculoskeletal and Pain Management Program to include select Cigna Medicare Advantage customers.
Beginning June 1, 2021, precertification requests for affected services, including major joint surgery services related to the hip, knee, and shoulder and interventional pain management procedures must be submitted to eviCore instead of Cigna.
CIGNA MEDICARE ADVANTAGE PRIOR AUTHORIZATION PROGRAM – ORIENTATION SESSION SCHEDULE.
Cigna Medicare Advantage has partnered with eviCore healthcare to provide patients with access to high quality, medically appropriate care that is consistent with evidence-based treatment guidelines.
The following procedures will require prior authorization for patients covered by Cigna Medicare Advantage
- Major Joint Services (Hip, Knee, Shoulder)
- Interventional Pain Management Procedures
eviCore healthcare will be leading online orientation sessions designed to assist you and your staff with the new program. For times and how to register click here.
Step Therapy Required for Part B Drugs and Biologics, Revised 2/24/21
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Cigna Medicare Advantage Prior Authorization Program – Orientation Session Schedule
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Cigna Medicare Advantage Musculoskeletal and Pain Management Program is Expanding Beginning 6/1/2021
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Cigna MA 2nd Qtr News 5/11/2021
Feature Article: Engaging with Patients Virtually, Cigna’s Virtual Care Reimbursement Policy
Policy Updates:
- Preventive Care Services
- Precertification
- Clinical, Reimbursement, and Administrative
General News
- Claim Denial preventive tips
- Appeal Reminders
- and many more to numerous to add
Webinar Schedule for Digital Solutions:
| Topic | Date | Time (CT) | Length | Meeting # |
|---|---|---|---|---|
| Eligibility and Benefits /Cigna Cost of Care Estimator | Wednesday, May 12, 2021 | 12:00 | 60 min | 179 626 8334 |
| EFT Enrollment, Online Remittance, and Claim Status Inquiry | Monday, May 17, 2021 | 11:00 | 60 min | 179 602 5133 |
| Online Appeal and Claim Reconsideration | Wednesday, May 19, 202 | 11:00 | 60 min | 179 487 2665 |
Website Access Manager Training | Wednesday, May 26, 2021 | 11:00 | 60 min | 179 079 6479 |
| CignaforHCP.com Overview | Tuesday, June 1, 2021 | 1:30 | 90 mins | 179 702 7790 |
| Eligibility and Benefits /Cigna Cost of Care Estimator | Wednesday, June 9, 2021 | 11:00 | 60 min | 179 319 4586 |
| EFT Enrollment, Online Remittance, and Claim Status Inquiry | Wednesday, June 16, 2021 | 11:00 | 60 min | 179 225 1773 |
| Online Appeal and Claim Reconsideration | Monday, June 21, 2021 | 11:00 | 60 min | 179 162 7760 |
| Website Access Manager Training | Monday, June 28, 2021 | 11:00 | 60 min | 179 940 8512 |
Re: Cigna MA Referrals
This is a cut and paste from:
(Revised 04/26/21) The current Public Health Emergency (PHE) period has been extended through 07/20/2021. https://www.phe.gov/emergency/news/healthactions/phe/Pages/COVID-15April2021.aspx
Referral Requirements
In-Network Providers: Referral requirements (if required by customer’s benefit plan) are waived for in-network provider services through 07/20/2021.
Out of Network Providers: Referral requirements (if required by customer’s benefit plan) are waived for out-of-network provider services through 07/20/2021.
Health Plan Representatives Updated 2/25/2021
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