Private Payer: Cigna Implementing Single Appeal Reviews


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Topic Private Payer: Cigna Implementing Single Appeal Reviews
Background For certain business units and types of appeals, Cigna historically has offered second-level appeals to health care professionals who were not satisfied with the resolution of a first-level review. Beginning July 1, 2013, Cigna will no longer offer second-level appeals. All appeals will follow a thorough single appeal review process and will be completed within 60 days.
Regulating Body Cigna Network Newsletter, April 2013
Compliance Date 7/1/2013
Consequences Appeals submitted without the "Request for Provider Payment Review Form" may not be processed correctly.
Next Steps Practices should utilize the "Request for Provider Payment Review Form" on the Cigna website and also review the Claim Adjustment and Appeals Guidelines on the Cigna website. Links to both of these can be found in the April 2013 Cigna Network Newsletter at http://www.cigna.com/assets/docs/health-care-professionals/863850-2Q13-NETWORK-NEWS-final.pdf.​
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