Practice Management

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  • 1.  Cigna HealthSpring

    Posted 08-16-2018 14:47
    Hi,

    We have received a number of remits from Cigna HealthSpring that show a "WO" reduction in payment stating it is a "recovery of a previous overpayment," but it is showing on claims that have not previously been paid, so a previous overpayment is not possible.  It also references the check that is connected to the remit, not a previous check number.  Basically, we are getting paid less than the Medicare allowed amount on these claims with no apparent reason.  We also have not received any refund requests from the payer.

    All attempts to contact someone at Cigna Healthspring regarding this issue have been unsuccessful.  Has anyone else encountered this problem?  Or does anyone have a contact at Cigna Healthspring they'd be willing to share?  We have tried to go through our local Medical Society, but even they are having trouble finding a contact.

    Thanks,
    Vicki

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    Vicki Parikh
    Practice Administrator
    Mid-Delaware Imaging
    Dover DE
    3027349888
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  • 2.  RE: Cigna HealthSpring

    Posted 09-17-2018 09:33
    ​I did not see a response to your post.
    We do have several contacts that have helped us previously they are out of the Philadelphia area but they may be able to get you someone in your region.
     These contacts are continuously changing; I am not sure if they are still active, but it may be a good place to start.
    I will list them below

    Mike Taylor
    Provider Data Senior Associate
    PH 267-238-5672
    Michael.Taylor2@healthspring.com

    Anne.Frank@healthspring.com

    Sean Cosgrove, Manager of Contracting for PA and Mid-Atlantic
    PH 267-238-5860

    Good Luck!
    Holly

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    Holly DeCamp
    Director of Credentialing
    Medical Billing & Management Services
    State College PA
    (814) 235-6682
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  • 3.  RE: Cigna HealthSpring

    Posted 09-17-2018 09:50
    Vicki - We're not having this issue (yet, anyway) but you might consider contacting the insurance commissioner's office.

    We're having a similar situation at the moment with Amerihealth Medicaid and I'm pretty close to contacting DMAP about it. (Since the insurance commissioner apparently can't help with Medicaid issues.)

    Good luck,
    Rick





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    Rick Sylvanus

    Operations Manager

    Southern Delaware Imaging Associates