Cigna - Patient Billing Reminder

I received a great piece of news today from Cigna. Their July 2013 Network News article was filled with a lot of good information. This is one piece I thought worth sharing because there is always a question of when and how much to collect from a patient. This helps clarify that for their networks.

Patient billing reminder

It is important to remember that there are program requirements and administrative guidelines in place that include how and when to bill your Cigna patients for covered services. As outlined in the Denied Payment and Participant Non-liability section of the Cigna Reference Guide for physicians, hospitals, ancillaries, and other health care professionals, if these requirements and guidelines are not followed, payment cannot be recovered by charging the patient for the covered services.

Coinsurance plans

For your Cigna patients with a coinsurance plan (a deductible plan or a plan that requires individuals to pay a percentage of the covered charges after meeting the deductible amount), submit claims to Cigna (or its designee). If you used the Cigna Cost of Care Estimator®, you may bill the patient for the amount inidicated as their payment responsibility. Otherwise, you will receive an explanation of payment (EOP) indicating the individual’s payment responsibility. Refer to this EOP before you bill your patients.

Copay plans

For your Cigna patients with a copay plan (a fixed dollar amount they owe per service), the applicable copays may be collected at the time of service. Refer to your patients’ Cigna ID card for the copay amount.

To ensure proper billing, please be aware of these requirements. Log in to CignaforHCP.com > Resources > Reference Guides > Medical Reference Guides > Health Care Professional Reference Guides for information on billing requirements.

http://www.cigna.com/customer_care/healthcare_professional/newsletters/July_2013/billing-0713