Billing & payment news

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

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Coding policies going into effect September 23

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

June 29, 2025

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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

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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

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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

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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

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Reprocessing 2024 & 2025 anesthesia claims

Since Jan. 1, 2024, anesthesia claims have been incorrectly overpaid. We’ll follow our corrections to payments policy to recoup the overpayments.

June 26, 2025

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Seeing in prism why a claim denied is easier than ever

We recently improved the Claims section in prism, pulling all claim denial details and rationale into one place. No additional buttons to click or external resources to access.

June 25, 2025

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