Provider Manual - Cigna Official Site
2014ProviderManualCentral GeorgiaINT 14 18263 08112014 2014 Cigna
Table of ConTenTsMeMber inforMaTionEligibility Verification2014 ID CardsMaximum Out-of-Pocket (MOOP)Member Hold HarmlessMember ConfidentialityMember Rights and ResponsibilitiesAdvance Medical DirectivesBenefits and ServicesEmergency Services and Care After HoursExcluded ServicesGrievance and Appeal ProcessDual Eligible MembersCigna-HealthSpring Cost-Sharing ChartMedicaid Coverage GroupsContinuity of Care1112222566678889Provider inforMaTionProviders Designated as Primary Care Physicians (PCPs)The Role Of The Primary Care Physician (PCP)The Role of the Specialist PhysicianAdministrative, Medical and/or Reimbursement Policy ChangesCommunication Among ProvidersProvider Marketing GuidelinesMember Assignment To New PCPProvider ParticipationPlan Notification Requirements For ProvidersClosing Patient PanelsMedical Record StandardsAccess and Availability Standards For ProvidersPhysician Rights and ResponsibilitiesProvision of Health Care ServicesDelegation991010101111121213131313141515Hs ConneCTExperience the Ease of HSConnect1515CredenTialinG and reCredenTialinG ProGraMPractitioner Selection CriteriaApplication ProcessCredentialing and Recredentialing ProcessOffice Site EvaluationsPractitioner RightsOrganizational Provider Selection CriteriaOrganizational Provider Application and RequirementsOrganizational Site SurveysCredentialing – Accreditation for DME, Orthotics and Prosthetic ProvidersSNF – Site Visit requirementsCredentialing Committee/ Peer Review ProcessNon-Discrimination in the Decision Making ProcessProvider NotificationAppeals Process & Notification of AuthoritiesConfidentiality of Credentialing InformationOngoing MonitoringProvider Directory161616161717171717181818181818191919
ClaiMsClaims SubmissionCoordination of Benefits and Subrogation GuidelinesWorker’s re Plan effeCTiveness daTa and inforMaTion seT (Hedis )24sTars GuidanCeStar Rating ComponentsHealth ReformStar Measure WeightingStar Rating Timeline2525262627beHavioral HealTH27HealTH serviCesGoalsDepartmental FunctionsPrior AuthorizationOutpatient Prior Authorization DepartmentDecisions and Time FramesRetrospective ReviewConcurrent ReviewReadmissionThe Role of the Cigna-HealthSpring ACCM (Acute Care Case Manager)Discharge Planning/Acute Care ManagementAdverse DeterminationsReferral ProcessReferral GuidelinesSelf ReferralsCase Management ServicesContinuity of Care2828292930313132333333343535353537referral ProCessSelf ReferralReferral ProcessPrimary Care Physician’s Referral ResponsibilitiesSpecialist Physician’s Referral Responsibilities3738383839CiGna HoMe delivery PHarMaCy39QualiTy ManaGeMenT ProGraMOverviewQuality Management ProgramQuality Improvement Committee (QIC)39394041CorPoraTe CoMPlianCe ProGraMOverviewFraud, Waste, and Abuse414141MediCare advanTaGe ProGraM reQuireMenTs42disPuTe resoluTion44
aPPendiXQuick Reference GuidePrior Authorization ListBehavioral Health Services Quick Facts and Phone GuideAdvance Directive: GeorgiaSurgical Procedures Excluded from Payment in ASC’s for 2014Clinical Practice Guidelines45464750516974
MeMber inforMaTioneligibility verificationAll participating providers are responsible forverifying a member’s eligibility at each and everyvisit. Please note that membership data is subject tochange. The Center for Medicare and Medicaid Service(CMS) retroactively terminates members for variousreasons. When this occurs, the Cigna-HealthSpringclaim recovery unit will request a refund from theprovider. The provider must then contact CMSEligibility to determine the member’s actual benefitcoverage for the date of service in question.You can verify member eligibility the following ways: Call the Health Plan – You must call the HealthPlan to verify eligibility when the member cannotpresent identification or does not appear on yourmonthly eligibility list. Please note, the HealthPlan should have the most updated information,therefore, call the Health Plan for accuracy. HSConnect – The Cigna-HealthSpring webportal, HSConnect, allows our providers to verifymember eligibility online through visiting . Through our Interactive Voice Response (IVR)System at 1-800-230-6138. The IVR Systemis available 24 hours a day, 7 days a week. Ask to see the member’s Identification Card –Each member is provided with an individualmembership identification card. Noted on the IDcard is the member’s identification number, plancode, name of PCP, co-payment, and effective date.Since changes do occur with eligibility, the cardalone does not guarantee the member is eligible. Pursue additional proof of identification – EachPCP and specialist office is provided with amonthly Eligibility report upon request which listsnew and current Cigna-HealthSpring memberswith their effective dates. Please be sure to referto the most current month’s eligibility listing.2014 id Cards2014 MA ID CARD Plan Name Contract & PBP # Health Plan (80840)Member ID: Member ID Name: Member Name PCP: PCP PCP Phone: PCP Phone Number Network: PCP Network Barcode This card does not guarantee coverage or payment. Services may require a referral by the PCP or authorization by the health plan. Medicare limiting charges apply. MembersCustomer Service: number TTY: TTY number 24-Hour Health Information Line: Phone Number Medical ProvidersProvider Services: number Authorization/Referral: number Claims: claims address Copays: Copay Amounts Website: URL 2014 MAPD ID CARD Plan Name Contract & PBP # Health Plan (80840)Member ID: Member ID Name: Member Name PCP: PCP PCP Phone: PCP Phone Number Network: PCP Network Copays: Copay Amounts RxBin: RxBIN RxPCN: RxPCN Barcode This card does not guarantee coverage or payment. Services may require a referral by the PCP or authorization by the health plan. Medicare limiting charges apply. MembersTTY: TTY number Customer Service: number 24-Hour Health Information Line: Phone Number Medical ProvidersProvider Services: number Authorization/Referral: number Claims: claims address Pharmacy ProvidersHelp Desk: number Claims: claims address Website: URL 1
Maximum out-of-Pocket (MooP)The Maximum Out-of-Pocket (MOOP) benefit is now apart of all Cigna-HealthSpring Benefit Plans. Membershave a limit on the amount they will be required to payout-of-pocket each year for medical services which arecovered under Medicare Part A and Part B. Once thismaximum out-of-pocket expense has been reached,the member no longer is responsible for any out-ofpocket expenses, including any cost shares, for theremainder of the year for covered Part A and Part Bservices (excluding the members’ Medicare Part Bpremium and Cigna-HealthSpring plan premium).Member Hold HarmlessParticipating providers are prohibited from balancebilling Cigna-HealthSpring members including, butnot limited to, situations involving non-payment byCigna-HealthSpring, insolvency of Cigna-HealthSpring,or Cigna-HealthSpring’s breach of its Agreement.Provider shall not bill, charge, collect a deposit from,seek compensation or reimbursement from, or haveany recourse against members or persons, other thanCigna-HealthSpring, acting on behalf of members forCovered Services provided pursuant to the ParticipatingProvider’s Agreement. The provider is not, however,prohibited from collecting co-payments, co-insurancesor deductibles for covered services in accordance withthe terms of the applicable member’s Benefit Plan.Member ConfidentialityAt Cigna-HealthSpring, we know our members’ privacy isextremely important to them, and we respect their rightto privacy when it comes to their personal informationand health care. We are committed to protecting ourmembers’ personal information. Cigna-HealthSpringdoes not disclose member information to anyonewithout obtaining consent from an authorized person(s),unless we are permitted to do so by law. Becauseyou are a valued provider to Cigna-HealthSpring,we want you to know the steps we have taken toprotect the privacy of our members. This includeshow we gather and use their personal information.Cigna-HealthSpring’s privacy practices apply to all ofCigna-HealthSpring’s past, present, and future members.When a member joins a Cigna-HealthSpringMedicare Advantage plan, the member agrees togive Cigna-HealthSpring access to Protected HealthInformation. Protected Health Information (“PHI”),as defined by the Health Insurance Portability andAccountability Act of 1996 (“HIPAA”), is informationcreated or received by a health care provider, healthplan, employer or health care clearinghouse, that: (i)relates to the past, present, or future physical or mentalhealth or condition of an individual, the provisionof health care to the individual, or the past, present2or future payment for provision of health care to theindividual; (ii) identifies the individual, or with respectto which there is a reasonable basis to believe theinformation can be used to identify the individual;and (iii) is transmitted or maintained in an electronicmedium, or in any form or medium. Access to PHIallows Cigna-HealthSpring to work with providers,like yourself, to decide whether a service is a CoveredService and pay your clean claims for Covered Servicesusing the members’ medical records. Medical recordsand claims are generally used to review treatmentand to do quality assurance activities. It also allowsCigna-HealthSpring to look at how care is deliveredand carry out programs to improve the quality of careCigna-HealthSpring’s members receive. This informationalso helps Cigna-HealthSpring manage the treatmentof diseases to improve our members’ quality of life.Cigna-HealthSpring’s members have additional rightsover their health information. They have the right to: Send Cigna-HealthSpring a written request to seeor get a copy of information about them, or amendtheir personal information that they believe isincomplete or inaccurate. If we did not create theinformation, we will refer Cigna-HealthSpring’smember to the source of the information. Request that we communicate with them aboutmedical matters using reasonable alternative meansor at an alternative address, if communicationsto their home address could endanger them. Receive an accounting of Cigna-HealthSpring’sdisclosures of their medical information, exceptwhen those disclosures are for treatment,payment or health care operations, or thelaw otherwise restricts the accounting.As a Covered Entity under HIPAA, providersare required to comply with the HIPAA PrivacyRule and other applicable laws in order to protectmember PHI. To discuss any breaches of theprivacy of our members, please contact ourHIPAA Privacy Officer at 1-615-236-6157.Member rights and responsibilitiesCigna‑HealthSpring members have the followingrights: The right to be treated with dignity and respectMembers have the right to be treated with dignity,respect, and fairness at all times. Cigna-HealthSpringmust obey laws against discrimination that protectmembers from unfair treatment. These laws say thatCigna-HealthSpring cannot discriminate againstmembers (treat members unfairly) because of a person’srace, disability, religion, gender, sexual orientation,health, ethnicity, creed, age, or national origin. Ifmembers need help with communication, such as help
from a language interpreter, they should be directed tocall Member Services. Member Services can alsohelp members in filing complaints about access tofacilities (such as wheel chair access). Members canalso call the Office for Civil Rights at 1-800-368-1019or TTY/TDD 1-800-537-7697, or the Office forCivil Rights in their area for assistance.The right to the privacy of medical recordsand personal health informationThere are federal and state laws that protect theprivacy of member medical records and personalhealth information. Cigna-HealthSpring keepsmembers’ personal health information private asrequired under these laws. Any personal informationthat a member gives Cigna-HealthSpring is protected.Cigna-HealthSpring staff will make sure thatunauthorized people do not see or change memberrecords. Generally, we will get written permission fromthe member (or from someone the member has givenlegal authority to make decisions on their behalf)before we can give member health information toanyone who is not providing the member’s medicalcare. There are exceptions allowed or required by law,such as release of health information to governmentagencies that are checking on quality of care.The laws that protect member privacy give them rightsrelated to getting information and controlling howtheir health information is used. Cigna-HealthSpringis required to provide members with a notice thattells them about these rights and explains howCigna-HealthSpring protects the privacy of their healthinformation. For example, members have the right tolook at their medical records, and to get copies of therecords (there may be a fee charged for making copies).Members also have the right to ask plan providers tomake additions or corrections to their medical records(if members ask plan providers to do this, they willreview member requests and figure out whether thechanges are appropriate). Members have the right toknow how their health information has been givenout and used for routine and non-routine purposes. Ifmembers have questions or concerns about privacyof their personal information and medical records,they should be directed to call Member Services.Cigna-HealthSpring will release a member’s information,including prescription drug event data, to Medicare,which may release it for research and other purposes thatfollow all applicable Federal statutes and regulations.The right to see participating providers,get covered services, and get prescriptionsfilled within a reasonable period of timeMembers will get most or all of their health care fromparticipating providers, that is, from doctors and otherhealth providers who are part of Cigna-HealthSpring.Members have the right to choose a participatingprovider (Cigna-HealthSpring will work with membersto ensure they find physicians who are accepting newpatients). Members have the right to go to a women’shealth specialist (such as a gynecologist) without areferral. Members have the right to timely access totheir providers and to see specialists when care froma specialist is needed. Members also have the rightto timely access to their prescriptions at any networkpharmacy. “Timely access” means that members canget appointments and services within a reasonableamount of time. The Evidence of Coverage explains howmembers access participating providers to get the careand services they need. It also explains their rights to getcare for a medical emergency and urgently needed care.The right to know treatment choices andparticipate in decisions about their health careMembers have the right to get full information fromtheir providers when they receive medical care, andthe right to participate fully in treatment planning anddecisions about their health care. Cigna-HealthSpringproviders must explain things in a way that memberscan understand. Members have the right to know aboutall of the treatment choices that are recommended fortheir condition including all appropriate and medicallynecessary treatment options, no matter what their costor whether they are covered by Cigna-HealthSpring.This includes the right to know about the differentMedication Management Treatment ProgramsCigna-HealthSpring offers and those in which membersmay participate. Members have the right to be toldabout any risks involved in their care. Members mustbe told in advance if any proposed medical care ortreatment is part of a research experiment and be giventhe choice of refusing experimental treatments.Members have the right to receive a detailed explanationfrom Cigna-HealthSpring if they believe that a planprovider has denied care that they believe they areentitled to receive or care they believe they shouldcontinue to receive. In these cases, members mustrequest an initial decision. “Initial decisions” arediscussed in the members’ Evidence of Coverage.Members have the right to refuse treatment.This includes the right to leave a hospital orother medical facility, even if their doctor advisesthem not to leave. This also includes the right tostop taking their medication. If members refusetreatment, they accept responsibility for whathappens as a result of refusing treatment.The right to use advance directives (suchas a living will or a power of attorney)Members have the right to ask someone such as afamily member or friend to help them with decisionsabout their health care. Sometimes, people become3
unable to make health care decisions for themselvesdue to accidents or serious illness. If a member wantsto, he/she can use a special form to give someonethey trust the legal authority to make decisions forthem if they ever become unable to make decisionsfor themselves. Members also have the right to givetheir doctors written instructions about how theywant them to handle their medical care if they becomeunable to make decisions for themselves. The legaldocuments that members can use to give their directionsin advance of these situations are called “advancedirectives.” There are different types of advancedirectives and different names for them. Documentscalled “living wills” and “powers of attorney forhealth care” are examples of advance directives.If members decide that they want to have an advancedirective, there are several ways to get this type of legalform. Members can get a form from their lawyer, froma social worker, from Cigna-HealthSpring, or fromsome office supply stores. Members can sometimesget advance directive forms from organizations thatgive people information about Medicare. Regardlessof where they get this form, keep in mind that it is alegal document. Members should consider having alawyer help them prepare it. It is important to sign thisform and keep a copy at home. Members should givea copy of the form to their doctor and to the personthey name on the form as the one to make decisionsfor them if they can’t. Members may want to givecopies to close friends or family members as well.If members know ahead of time that they are goingto be hospitalized and they have signed an advancedirective, they should take a copy with them to thehospital. If members are admitted to the hospital,the hospital will ask them whether they have signedan advance directive form and whether they have itwith them. If members have not signed an advancedirective form or does not have a copy availableduring admission, the hospital has forms availableand will ask if the member wants to sign one.Remember, it is a member’s choice whether he/she wants to fill out an advance directive (includingwhether they want to sign one if they are in thehospital). According to law, no one can deny them careor discriminate against them based on whether or notthey have signed an advance directive. If members havesigned an advance directive and they believe that adoctor or hospital has not followed the instructions in it,members may file a complaint with their State Board ofMedicine or appropriate state agency (this informationcan be found in the member’s Evidence of Coverage).4The right to make complaintsMembers have the right to make a complaint if theyhave concerns or problems related to their coverageor care. Members or an appointed/authorizedrepresentative may file “Appeals,” “grievances,” concernsand coverage determinations. If members make acomplaint or file an appeal or coverage determination,Cigna-HealthSpring must treat them fairly (i.e., notdiscriminate against them) because they made acomplaint or filed an appeal or coverage determination.To obtain information relative to appeals, grievances,concerns and/or coverage determinations, membersshould be directed to call Member Services.The right to get information about theirhealth care coverage and costThe Evidence of Coverage tells members what medicalservices are covered and what they have to pay. Ifthey need more information, they should be directedto call Member Services. Members have the rightto an explanation from Cigna-HealthSpring aboutany bills they may get for services not covered byCigna-HealthSpring. Cigna-HealthSpring must tellmembers in writing why Cigna-HealthSpring willnot pay for or allow them to get a service and howthey can file an appeal to ask Cigna-HealthSpring tochange this decision. Staff should inform memberson how to file an appeal, if asked, and should directmembers to review their Evidence of Coveragefor more information about filing an appeal.The right to get information aboutCigna‑HealthSpring, plan providers,drug coverage, and costsMembers have the right to get information aboutthe Cigna-HealthSpring plans and operations. Thisincludes information about our financial condition,about the services we provide, and about our healthcare providers and their qualifications. Members havethe right to find out from us how we pay our doctors.To get any of this information, members should bedirected to call Member Services. Members havethe right to get information from us about their PartD prescription coverage. This includes informationabout our financial condition and about our networkpharmacies. To get any of this information, staffshould direct members to call Member Services.The right to get more information about members rightsMembers have the right to receive information abouttheir rights and responsibilities. If members havequestions or concerns about their rights and protections,they should be directed to call Member Services.members can also get free help and information fromtheir State Health Insurance Assistance Program(SHIP). In addition, the Medicare program has written
a booklet called Members Medicare Rights andProtections. To get a free copy, members should bedirected to call 1-800-MEDICARE (1-800-633-4227).TTY users should 1-877-486-2048. members cancall 24 hours a day, 7 days a week. Or, members canvisit www.medicare.gov on the web to order thisbooklet or print it directly from their computer.The right to take action if a memberthinks they have been treated unfairly ortheir rights are not being respectedIf members think they have been treatedunfairly or their rights have not been respected,there are options for what they can do. If members think they have been treatedunfairly due to their race, color, national origin,disability, age, or religion, we must encouragethem to let us know immediately. They can alsocall the Office for Civil Rights in their area. For any other kind of concern or problemrelated to their Medicare rights and protectionsdescribed in this section, members should beencouraged to call Member Services. memberscan also get help from their State HealthInsurance Assistance Program (SHIP).Cigna‑HealthSpring members havethe following responsibilities:Along with certain rights, there are also responsibilitiesassociated with being a member of Cigna-HealthSpring.Members are responsible for the following: To become familiar with their Cigna-HealthSpringcoverage and the rules they must follow toget care as a member. members can use theirCigna-HealthSpring Evidence of Coverage andother information that we provide them to learnabout their coverage, what we have to pay, andthe rules they need to follow. Members shouldalways be encouraged to call Member Servicesif they have any questions or complaints. To advise Cigna-HealthSpring if theyhave other insurance coverage. To notify providers when seeking care (unlessit is an emergency) that they are enrolledwith Cigna-HealthSpring and present theirplan enrollment card to the provider. To give their doctors and other providers theinformation they need to provide care for them andto follow the treatment plans and instructions thatthey and their doctors agree upon. Members mustbe encouraged to ask questions of their doctors andother providers whenever the member has them. To act in a way that supports the care given toother patients and helps the smooth running oftheir doctor’s office, hospitals, and other offices. To pay their plan premiums and any co-paymentsor coinsurances they may have for the CoveredServices they receive. Members must also meettheir other financial responsibilities that aredescribed in their Evidence of Coverage. To let Cigna-HealthSpring know if they have anyquestions, concerns, problems, or suggestionsregarding their rights, responsibilities, coverage,and/or Cigna-HealthSpring operations. To notify Cigna-HealthSpring Member Servicesand their providers of any address and/orphone number changes as soon as possible. To use their Cigna-HealthSpring planonly to access services, medicationsand other benefits for themselves.advance Medical directivesThe Federal Patient Self-Determination Actensures the patient’s right is to participate in healthcare decision-making, including decisions aboutwithholding resuscitative services or declining/withdrawing life sustaining treatment. In accordancewith guidelines established by the Centers forMedicare and Medicaid Services (CMS), HEDISrequirements, and our own policies and procedures,Cigna-HealthSpring requires all participatingproviders to have a process in place pursuant tothe intent of the Patient Self Determination Act.All providers contracted directly or indirectlywith Cigna-HealthSpring may be informed by themember that the member has executed, changed,or revoked an advance directive. At the time aservice is provided, the provider should ask themember to provide a copy of the advance directiveto be included in his/her medical record.If the Primary Care Physician (PCP) and/or treatingprovider cannot as a matter of conscience fulfillthe member’s written advance directive, he/shemust advise the member and Cigna-HealthSpring.Cigna-HealthSpring and the PCP and/or treatingprovider will arrange for a transfer of care.Participating providers may not condition theprovision of care or otherwise discriminate againstan individual based on whether the individual hasexecuted an advance directive. However, nothing inThe Patient Self-Determination Act precludes theright under state law of a provider to refuse to complywith an advance directive as a matter of conscience.To ensure providers maintain the required processesto Advance Directives, Cigna-HealthSpringconducts periodic patient medical record reviewsto confirm that required documentation exists.5
benefits and servicesAll Cigna-HealthSpring members receive benefits andservices as defined in their Evidence of Coverage (EOC).Each month, Cigna-HealthSpring makes available toeach participating Primary Care Physicians a list of theiractive members. Along with the member’s demographicinformation, the list includes the name of the Planin which the member enrolled. Please be aware thatrecently-terminated members may appear on the list.(See “Eligibility Verification” section of this manual).Cigna-HealthSpring encourages its membersto call their Primary Care Physician to scheduleappointments. However, if a Cigna-HealthSpringmember calls or comes to your office for an unschedulednon-emergent appointment, please attempt toaccommodate the member and explain to them youroffice policy regarding appointments. If this problempersists, please contact Cigna-HealthSpring.emergency services and Care after HoursEmergency ServicesAn emergency is defined by Cigna-HealthSpring asthe sudden onset of a medical condition with acutesymptoms. A member may reasonably believe that thelack of immediate medical attention could results in: Permanently placing the member’s health in jeopardy Causing serious impairments to body functions Causing serious or permanent dysfunctionof any body organ or partIn the event of a perceived emergency, membershave been instructed to first contact their PrimaryCare Physician for medical advice. However, if thesituation is of such a nature that it is life threatening,members have been instructed to go immediately tothe nearest emergency room facility. Members whoare unable to contact their PCP prior to receivingemergency treatment have been instructed tocontact their PCP as soon as is medically possibleor within forty-eight (48) hours after receiving care.The PCP will be responsible for providing andarranging any necessary follow-up services.For emergency services within the service area, the PCPis responsible for providing, directing, or authorizing amember’s emergency care. The PCP or his/her designeemust be available twenty-four (24) hours a day, seven(7) days a week to assist members needing emergencyservices. The hospital may attempt to contact the PCP fordirection. Members have a co-payment responsibility foroutpatient emergency visits unless an admission results.For emergency services outside the service area,Cigna-HealthSpring will pay reasonable charges foremergency services received from non-participating6providers if a member is injured or becomes illwhile temporarily outside the service area. Membersmay be responsible for a co-payment for eachincident of outpatient emergency services at ahospital’s emergency room or urgent care facility.Urgent ServicesUrgent Care services are for the treatment ofsymptoms that are non-life threatening but thatrequire immediate attention. The member must firstattempt to receive care from his/her PCP. Treatmentat a participating Urgent Care Center will be coveredby Cigna-HealthSpring without a referral.Continue or Follow‑up TreatmentContinuing or follow-up treatment, except by the PCP,whether in or out of service area, is not covered byCigna-HealthSpring unless specifically authorizedor approved by Cigna-HealthSpring. Payment forcovered benefits outside the service area is limitedto medically necessary treatment required beforethe member can reasonably be transported to aparticipatin
HSConnect – The Cigna-HealthSpring web portal, HSConnect, allows our providers to verify member eligibility online through visiting https:// . Cigna-HealthSpring’s past, present, and future members. When a member joins a Cigna-Healt
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