Timely filing Limit for CIGNA insurance - New updates
CIGNA will adopt a common time frame for health care professionals to follow for submitting claims to CIGNA. Except where state law requires a longer time frame, the claim filing limit will change from 180 days to 90 days for participating health care professionals. The changes to the claim filing time frame will occur in phases, with the initial phase effective on August 1, 2011.
Providers will be notified in writing of any changes and receive an amendment to their agreement, or they will be contacted by a CIGNA representative. The claim filing time change also applies to health care professionals whose CIGNA contract includes GWH-CIGNA business. Certain states have regulatory requirements that supersede the CIGNA time frames, and health care professionals in these states will have a claim filing limit that meets state requirements.
* When CIGNA is the primary payer, claims must be received by CIGNA within 90 days of the date of service to be considered for payment.
* When CIGNA is the secondary payer, the claim must be submitted within 90 days of the receipt by the health care professional of the Explanation of Payment from the primary payer.
Only participating health care professionals who receive a notification and amendment to their agreement from CIGNA, or who are newly contracted with CIGNA, are affected by this change on August 1 and November 1, 2011. There will be additional phases in 2012, and affected health care professionals will be notified in advance of any changes.
Effective August 1, 2011, the claim filing limit in provider agreements will change from 180 days to 90 days, for participating health care professionals who have received notification and an amendment to the agreement in AK, AR, AZ, CO, CT, DE, IL, IN, KS, LA, ME, MI, MO, NH, NY, OH, OK, RI, SC, TX, UT, VT, WI and WV.
Effective November 1, 2011 for CA, GA, KY, MA, MS, NV, PA, TN and WA.
Please note:
NY and TN will have a 120-day claim filing limit.
TX will have a 95-day claim filing limit.
Popular Posts
-
Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...
-
Urgent Care Centers are the Facilities that delivers Outpatient Medical Care usually for the conditions that does not require Hospital a...
-
The 2018 ICD 10 CM codes has been published and it is effective from October 1, 2017. These 2018 ICD-10-CM codes are to be used for discha...
-
Ambulance transportation is a covered service when the patient’s condition is such that the use of any other method of transportation would...
-
Modifier -26 identifies the physician's or professional component of a two-component (professional and technical) service. The physicia...
-
Myocardial perfusion imaging is being done to determine the significance or the extent of myocardial ischemia (or scar), or to assess my...
-
Therapeutic activities are considered medically necessary for patients needing a broad range of rehabilitative techniques that involve ...
-
Definition: The “-59” modifier is used to indicate a distinct procedural service. The physician may need to indicate that a procedure or...
-
Modifier 51 designates multiple procedures that are rendered at the same operative session or on the same day. Modifier -51 (multiple p...
-
Sentinel lymph node identification and biopsy typically involves a multidisciplinary approach. A nuclear medicine procedure called lymph...
Posts
