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Please share this newsletter with ALL of your office staff, especially insurance and billing managers! There are lots of changes!!
Westar
Westar employees have CIGNA coverage as of 01/01/2019. Please ask your Westar patients to present their new ID Cards so you can make a copy of the front and the back of the card. Since they now have CIGNA, all of these claims must go through Infinedi coded with PF48/Cigna 937N9 at the top of the claim. This will ensure that the Tax ID on the claim is changed to PCC’s and the claim will be paid through PCC. PCC will pay you for these claims once we have received the funds from CIGNA.
Cigna
No changes to our Cigna agreement. Please remember that all claims must be filed under PCC’s tax ID number in order to be eligible for payment. This is done automatically through Infinedi if you use PF48 Cigna 937N9 at the top of the claim.
Please limit claims to ONE DATE OF SERVICE per HCFA claim form. Providers that continue to list multiple dates of service on one claim, or carry a service date over from one claim to another, may forfeit their right to appeal Cigna’s payment of the claim if it is paid incorrectly.
If you need to check status on specific dates of service, please send us the Patient’s Name, ID Number, Date of Birth and Dates of Service in question by fax 316.263.7814 or email bdauner@pccnetwork.com Sometimes this can be easier than calling with all of the information. As always, please contact PCC first if you have questions on Cigna claims!
(Counties excluded from PCC’s Cigna agreement are shown on the attached fee schedule. If you are in one of those counties, please disregard this portion of the newsletter)
Aetna
There have been NO changes to the Aetna-PCC fee schedule for 2019. If you are receiving a different reimbursement for specific codes from Aetna, it is NOT because there was a change to our fee schedule.
Aetna continues to have two chiropractic networks in our area. If you belong to both networks you should be “in-network” for all area Aetna employers. Our network covers Spirit and City of Wichita, our network does NOT cover USD259 or the Wesley Preferred Network.
All PCC-Aetna claims will be reimbursed under the fee schedule enclosed with this newsletter.
Humana
PCC does NOT have the Humana Gold contract. Humana Gold claims should go directly to Medicare.
Please contact us at 316.263.7800 or 800.611.3048 with questions.
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