![]() ![]() That insure or administer group HMO, dental HMO, and other products or services in your state). ![]() Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Once logged on, you may review the Clear Claim Connection Frequently Asked Questions for more information.Ĭigna Healthcare is committed to providing solutions that can minimize your administrative costs while helping to reduce the complexity of doing business with us.įind an in-network doctor, dentist, or facility Clinical edit rationales, as well as edit sourcing, are provided for any code that is not allowed in Clear Claim Connection.Ĭlear Claim Connection is accessible through the Cigna for Health Care Providers portal at. 2 Editing Claims with Cigna HealthcareĬlaimsXten Clear Claim Connection TM, our code edit disclosure tool powered by McKesson, allows users to enter CPT and HCPCS coding scenarios and to immediately view the audit result. This policy is not designed to limit our right to require submission of medical records for precertification purposes. To view, click on 'Resources Claim Editing Procedures.' Types of clinical documentation that may be requested include: A specific list of Cigna Healthcare combinations that require documentation is available on the Cigna for Health Care Professionals website at. It is not an across the board requirement for all uses of these modifiers. The supporting documentation requirement is on selected code edits when modifier 25 or 59 is billed. modifier 59 - Non-Evaluation & Management (E/M) service codes that disallow with a CMS/NCCI Mutually Exclusive Edit designated by CMS as '1' 1.modifier 25 - Evaluation & Management (E/M) service codes that disallow with a CMS/NCCI Incidental Edit (also called Column 1/Column 2 Code Edits) designated by CMS as '1' 1. ![]()
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