Practice Management Alert

Does dealing with CIGNA Healthcare make you want to pull out your hair? If so, you're not alone and victory could soon be yours.
 
CIGNA announced Sept. 3 that it has reached a settlement with the 700,000 physicians who pummeled the Bloomfield, CT-based company with class-action lawsuits filed in state and federal courts. Put simply, the agreement requires CIGNA to stop being so difficult to work with.
 
Specifically, the settlement agreement requires CIGNA to pay physicians for claims in the cases of Shane v. Humana and Kaiser v. CIGNA, and stipulates that physicians may choose between two forms of payment: "payment from a $30 million settlement fund of a fixed amount," or "payment resulting from the resubmission of certain claims filed during the class period."
 
Further, CIGNA will have to:
 

appoint an external body to handle billing/payment disputes,
 

pay physicians for administering vaccines and other injectable drugs,
 

create a Web site that will provide detailed information about the company's claim coding policies and other payment guidelines,
 

limit physician fee schedule changes to once in a calendar year,
 

create a Physician Advisory Committee that will serve as a vehicle through which physicians can voice concerns and offer suggestions to CIGNA
 

eliminate the requirement that physicians submit copies of medical records to receive payment for most office visits occurring on the same day as surgeries and other procedures, and
 

pay interest on fully documented claims that aren't paid within the agreed-upon time limit.
 
The settlement agreement was submitted to the court for approval on Sept. 3. "CIGNA is to be commended for agreeing to change its business practices and improve its relationships with practicing physicians and their patients," said Donald Palmisano, MD, JD, president of the American Medical Association. "We are hopeful other health insurers will follow CIGNA's example."