Posts Tagged ‘appeal’

Cigna Has Imposed A Single Appeal Process As Of 7/1/13

In Uncategorized on August 23, 2013 at 6:30 pm

Per Cigna’s announcement (emphasis added):

Historically, for certain business units and types of appeals, we have offered second-level appeals to health care professionals who were not satisfied with the resolution of a first-level review.  Please be aware that beginning July 1, 2013, we will no longer offer second-level appeals.  All appeals will follow a thorough single appeal review process and will be completed within 60 days. This change establishes a consistent approach for health care professionals across Cigna’s network.

As a reminder, all appeals should be initiated in writing within 180 calendar days of the date of the initial payment or denial decision. If the appeal relates to a payment that we adjusted, the appeal should be initiated within 180 calendar days of the date of the last payment adjustment.

This new policy impacts medical billing clients only in that when you receive a request for information from your billing partner, you need to be sure to provide complete information in a timely manner, as that biller has only one chance to appeal denials going forward!