Billing & payment news

Void claims now appear on remittance advice with original claims

Since June 2024, void claims now appear on your remittance advice with the original claim adjustment.

June 29, 2025

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Simplifying EFT setup

Soon, we’ll simplify our electronic funds transfer (EFT) setup process in prism, making it easier for us to work together on your EFT setup and management needs.

June 29, 2025

Resolving claims denying incorrectly for no anatomical modifier

We're reprocessing claims that recently denied for no anatomical modifier when they shouldn't have.

June 29, 2025

Changes for Medicaid claims for select home health care services

Changes coming for Medicaid claims submissions for select home health care services

June 29, 2025

ER imaging claims reprocessing

We're adjusting ER imaging claims that rejected incorrectly for no authorization.

June 29, 2025

Upfront claim rejections for member mismatch

Review the criteria our system looks at to match a claim to one of our members. If any of these don’t match exactly what we have in our system, the claim will be rejected.

June 29, 2025

New coding policies posted to the Provider Manual

We recently posted the following policies to our Provider Manual.

June 29, 2025

IVF billing reminder

We want to remind you that if you are in our network you must bill us for in-vitro fertilization (IVF) treatments instead of charging our members upfront. The same applies for Cigna Healthcare members receiving care in Michigan, due to our Strategic Alliance with them.

June 29, 2025

Coding policies going into effect September 23

The following coding / reimbursement policies will go into effect Sept. 23, 2024.

June 29, 2025

New billing policies posted to the Provider Manual

The following billing and coding policies were recently posted to or updated in the Provider Manual’s billing policies webpage in June 2024.

June 29, 2025

Aligning commercial DME billing and coding with CMS

Starting Aug. 1, 2024, we’re aligning our commercial billing and coding requirements for durable medical equipment (DME) supplies to those defined by the Centers for Medicare and Medicaid Services (CMS).

June 29, 2025

New and updated billing policies now available

In alignment with industry standards, we’ve posted several new and updated billing policies to the Provider Manual.

June 29, 2025