HELPFUL REMINDERS

Tools for Improving Claim Processing

CIGNA currently uses ClaimCheck^® 8.5, a code auditing software, to expedite accurate claim processing. On May 23, 2011, CIGNA will update our ClaimCheck software to reflect Knowledge Base Version 47, NCCI Version 17.0 Column 1/Column 2 (Incidental) and Mutually Exclusive code edits.

You may view code edits by using Clear Claim Connection^TM. This disclosure tool allows users to enter CPT codes, Health Care Common Procedure Coding System (HCPCS) codes and immediately view the code audit results prior to submitting a claim. Clear Claim Connection shows NCCI edit definitions and the rationale behind a ClaimCheck edit. 

More ClaimCheck and Clear Claim Connection information is available on the CIGNA for Health Care Professionals website (www.cignaforhcp.com > eServices > View Claim Coding Edits). You will need to complete the registration process to log in if you are not registered for the CIGNA for Health Care Professionals website. Go to www.cignaforhcp.com and click ‘Register Now’, located in the left-side bar. You can also access the list through the Secured Provider Portal, www.gwhcignaforhcp.com.

Visit the Secured Provider Portal  (www.gwhcignaforhcp.com > Tools & Resources > Clinical Edit Verification) to learn more about code edits on claims associated with GWH-CIGNA ID cards.

Note: Claim coding edit results are guidelines and not a guarantee of claim payment.

Featured Article

• Cultural Competency - Increase Quality of Care and Improve Patient Compliance

Policy Updates

• Clinical, Reimbursement and Administrative Policy Updates
• Evaluation and Management Coding Review
• Preventive Care Coverage Update

Electronic Tools

• New eCourse Available
• Receive Your CIGNA Remittance Reports Online
• Transparent Cost of Care

Pharmacy Updates

• CIGNA Pharmacy Step Therapy Program to Expand
• New Value Prescription Drug List Option

Integration Updates

• Network Differences
• Ancillary Vendor and Facility Referrals
• Claim and Service Channels
• Brand Changes
• Revised GWH-CIGNA ID Cards
• Updates to the Secured Provider Portal
• Secure Websites

General Updates

• Eligibility and Benefit Enhancements
• New CIGNA Paper Claim and Correspondence Addresses and Fax Numbers
• Urgent Care for Non-emergencies

Helpful Reminders

• Reference Guides Updated
• Tell Us What’s Changed
• Use the Network
• Tools for Improving Claim Processing
• Access the Archives
• Go Green - Go Electronic