AAH, Cigna discuss transition issues

Sunday, September 30, 2007

NASHVILLE, Tenn. -AAHomecare held a conference call with Cigna Government Services officials in late August to address concerns over a claims backlog that has dogged the Jurisdiction C Medicare Administrative Contractor (MAC) ever since it took over from Palmetto GBA July 1.
"We felt compelled to express our strong concern with transition issues and we are working with Cigna to make sure claims are processed on a timely basis," said Walt Gorksi, vice president of government affairs for AAHomecare.
Heavy call volume has also frustrated providers trying to contact Cigna on the phone, said Raul Lopez, director of operations for Miami Lakes, Fla.-based Bayshore Dura Medical, who sits on the Jurisdiction C Advisory Council.
"Cigna anticipated 3,000 to 4,000 calls a day and they are still getting up to 20,000 calls a day," said Lopez.
Exacerbating the problems: Providers in Virginia and West Virginia moved from Jurisdiction B to C, leading to further billing problems, said Stephanie Hess, secretary and regulatory co-chair for the Virginia Association of Durable Medical Equipment Companies.
"Claims are being rejected for invalid reasons," she said. "CMN information, especially on oxygen, doesn't seem like it transitioned. For claims that were being paid through Jurisdiction B, now C is denying them and wanting copies of the CMNs."
Cigna has said it is working to fix the problems, and plans to hire additional staff for the call center.