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CIGNA/ASHN Update : Provider Contract Advisory

Friday, January 26, 2018   (0 Comments)
Posted by: Cherish Simmons
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The OANP has updates in regard to the new contract being offered to NDs from American Specialty Health Network(ASHN) on behalf of Cigna Health Insurance. It has come to our attention that ASHN may have issued a revised version of their contract with an improved fee schedule. However, it doesn't appear the revised contract has been distributed to all NDs. Since provider contracts are privileged and available only to practitioners, the OANP does not have a formal copy.

If you are interested in contracting to see CIGNA patients, consider the following:

  • Maintain out-of-network (OON, ie non-contracted) status and provide your patients a bill they can submit to the health plan themselves. OON benefits will vary by plan, are usually a lower percentage of allowable reimbursement rates. However, they provide some reimbursement directly to the patient and allow you to balance bill for the difference if you so choose.
  • Encourage your patients to register their concerns and complaints with their employers' HR departments. This feedback will help Cigna understand why NDs will not contract with them and hopefully provide an impetus for them to revise their policies.
  • Contact ASH and request the revised fee schedule.
  • Make sure the reimbursement rates are actually more favorable.
  • Check to make sure the medical necessity (pre-authorization) requirements for additional visits have been waived.
  • Limitations on routine laboratory tests have expanded.
  • You can negotiate your contracts! We have heard from at least one ND that has had some success in negotiating with Cigna/ASHN, and they have gotten partial approval of some codes. They are continuing to negotiate/renegotiate certain parts of the contract.

If you have negotiated with Cigna/ASHN and have received better rates, please feel free to share this information with us!

OANP's next legislative priority will be introducing a bill on pay parity for the 2019 legislative campaign. If you are interested in donating towards the legislative action fund, please click HERE.

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