Tag: HealthSpring (HCSC)
HealthSpring Change in Prior Auths
Change in prior authorization administration for DME services, effective March 1, 2026 |
Effective March 1, 2026, HealthSpring will manage prior authorizations for durable medical equipment services, as well as orthotic and prosthetic codes. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.
EviCore healthcare will continue to manage prior authorizations for DME services through Feb. 28, 2026.
What this means to your patients through Feb. 28, 2026 · Submit prior authorization requests with dates of service before March 1, 2026, to EviCore as usual. · Continue to refer to EviCore for the most updated prior authorization code lists. · There are no changes to the claims submission or appeals processes.
|
Key changes effective March 1, 2026 · DME providers will submit prior authorization requests directly to HealthSpring. · Submit prior authorization requests to HealthSpring for dates of services beginning March 1, 2026. Request prior authorization through Availity Essentials™, our provider portal. · A list of procedural codes requiring prior authorization is available on the clinical review page of our provider website, HealthSpring.com/Providers. · Any authorization issued prior to March 1 will remain valid for those dates and services. That means, any authorizations approved by EviCore before March 1 will remain effective with HealthSpring. You do not need to submit a new prior authorization request.
|
How to request prior authorization Request prior authorization through our provider portal, Availity Essentials. This portal is the preferred and fastest method. Refer to Availity for instructions on setting up an account and navigating the portal. If you prefer, you can also call 1-800-914-8252 or fax 1-877-451-5541. |
HealthSpring Plans by County
POET staff has done everything short of a full skeletal reconstruction to make the HealthSpring county page in the provider manual legible. They’ve stretched it. They’ve shrunk it. They’ve even converted it to Word and back to a PNG. It just didn’t have the backbone it needed.
If we were tibia honest, nothing worked.
So I, Sir Seymore Bones — resident WordPress writer and part-time osteo-optimizer — took pen in hand (metacarpals and all) to give everyone a little relief. When the formatting started rattling, I decided it was time to get to the bare bones of the issue.
I hope the map below helps you Sey-more, and make sense of the plans offered in our counties. We femur-ly believe this version is better. If it doesn’t… well, I promise I didn’t bone it up on purpose.
Stay humerus,
Sir Seymore Bones
HealthSpring Provider Manual 2026
Have you received your copy of the HealthSpring Provider Manual?
HealthSpring has a New Payor ID
PAYOR ID: 52192
Claims Address for paper claims: P.O. Box 23456 Chattanooga, TN. 37421
More on HealthSpring and CPL
Update: POET has been advised that the issue involving HealthSpring, CPL, and Polk County is related to a claims system error. HealthSpring has confirmed that they are currently in contract with CPL, and the issue is actively being worked on.
POET we keep you updated, as we receive information.
CPL Labs and HealthSpring
Just in from HealthSpring!
In Polk County, CPL Labs are not in network.
HealthSpring patients in Polk County should go to Quest or LabCorp.
HealthSpring Rollout
■ Important Updates for Physician Offices-New Plans Coming in 2026
New benefit plans under the HealthSpring name will roll out January 2026. For now, you can find articles about these changes on: MedicareProviders.Cigna.com …and in the Provider Newsroom.
■ Claims Contact Information
Jim Denman will no longer handle claims.
For more information, please call POET
■ Goodbye HSConnect – Hello Availity Essentials
Cigna MA has partnered with Availity Essentials for enhanced online tools. HSConnect and Cigna for HCP are no longer needed.
■ Verify eligibility & benefits
■ Verify primary care provider
■ View customer ID cards
■ View maximum-out-of-pocket amounts
■ Submit professional & institutional claims
■ Check claim status
■ View remittance advice
■ Access Cigna MA links (including prior authorizations & resources) via the Payer Space page
More from HealthSpring HCSC
New Benefit Plans will roll out under the HealthSpring (HS) name during the 2025 Annual Enrollment Period (AEP)
Beginning in 2026, you will see members enrolled in HealthSpring benefit plans. But until then physician staff and HS will continue to communicate through the Cigna Healthcare Channels, including the Provider Newsroom.
In September of this year (2025) HS will add a home page for providers. After that HS will continue to add resources to prepare the physician office and HS members for January 2026. Check out HealthSpring.com
Health Plan Representatives Updated 8/4/2025
The Health Plan Representatives List has been updated. This is a good tool to print and have close by when you have an issue.
The biggest change for claims issues will be HealthSpring (HCSC) formerly Cigna MA. Here is how:
- Email ALL claims issues to [email protected]
2. HealthSpring has supplied the spreadsheet that MUST be used. A link is provided below, or you may call POET, we will be glad to email you an electronic copy.
Only the columns with Red Lettering, need to be filled out by the Physician’s office.
4. Always feel free to copy [email protected] if you would like POET to be in the loop.
5. If you have a time sensitive, special, or just an issue you would like to discuss with POET, please call (936) 637-7638.
Recent Comments