Submitting requested medical records for claims processing
Follow this process when submitting requested medical records to ensure they're linked with the right claim.
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.
Resolving claims denying incorrectly for no anatomical modifier
We're reprocessing claims that recently denied for no anatomical modifier when they shouldn't have.
Changes for Medicaid claims for select home health care services
Changes coming for Medicaid claims submissions for select home health care services
ER imaging claims reprocessing
We're adjusting ER imaging claims that rejected incorrectly for no authorization.
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.
New coding policies posted to the Provider Manual
We recently posted the following policies to our Provider Manual.
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.
Coding policies going into effect September 23
The following coding / reimbursement policies will go into effect Sept. 23, 2024.
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.
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).
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.