Cigna healthspring timely filing 202112/9/2023 ![]() ![]() Medicare (Cigna Healthcare for Seniors): In accordance with Medicare processing rules, non-participating health care providers have 15 to 27 months to file a new claim.In Coordination of Benefits situations, timely filing is determined from the processing date indicated on the primary carrier's explanation of benefits (EOB) or explanation of payment (EOP).Provider agreement specifically allows for additional time.Applicable law requires a longer filing period.There are some exceptions to these deadlines. Remember: Your contract with Cigna Healthcare SM prohibits balance billing your patient if claims are denied because they were not submitted within the time frame outlined above. Cigna may not control the content or links of non-Cigna websites.If services are rendered on consecutive days, such as for a hospital confinement, the limit will be counted from the last date of service.Īs always, you can appeal denied claims if you feel an appeal is warranted. Selecting these links will take you away from to another website, which may be a non-Cigna website. This website is not intended for residents of New Mexico. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. LINA and NYLGICNY are not affiliates of Cigna.Īll insurance policies and group benefit plans contain exclusions and limitations. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT) (ii) Life Insurance Company of North America (“LINA”) (Philadelphia, PA) or (iii) New York Life Group Insurance Company of NY (“NYLGICNY”) (New York, NY), formerly known as Cigna Life Insurance Company of New York. That insure or administer group HMO, dental HMO, and other products or services in your state). Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. 2 The following services can be appealed.įind an in-network doctor, dentist, or facility If our Customer Service team cannot adjust the issue during that call, then our appeal process can be initiated through a written request. Many issues, including denials related to timely filing, incomplete claim submissions, and contract and fee schedule disputes may be quickly resolved through a real-time adjustment by providing requested or additional information. ![]() Most claim issues can be remedied quickly by providing requested information to a claim service center or contacting us.īefore beginning the appeals process, please call Cigna Healthcare Customer Service at 1(800) 88Cigna (882-4462) to try to resolve the issue. The payment appeal process is different from routine requests for follow-up inquiries on claim processing errors or missing claim information. Following the internal Cigna Healthcare process, arbitration may be used as a final resolution step.For claim denials relating to claim coding and bundling edits, a health care provider may have the option to request binding external review through the Billing Dispute Administrator.An appeal process for resolving contractual disputes regarding post-service payment denials and payment disputes 1.If issues cannot be resolved informally, Cigna Healthcare offers two options: Cigna Healthcare SM strives to informally resolve issues raised by health care providers on initial contact whenever possible. ![]()
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