A few bumps in the road

Friday, August 31, 2007

NASHVILLE, Tenn. - Cigna Government Services slipped into its role as the new Jurisdiction C Medicare Administrative Contractor July 1, and, so far, the transition has gone as well as expected, say sources.
"I think Cigna has tried to anticipate what the needs and issues were going to be," said Andrea Stark, a Medicare consultant with MiraVista. "In areas where they were deficient, they've rallied resources."
Cigna was awarded the contract after a protracted battle with former MAC Palmetto (See HME News, November 2006).
As with any transition there have been a few bumps, said Raul Lopez, director of operations for Bayshore Dura Medical in Miami Lakes, Fla., who attended a Jurisdiction C Advisory Council meeting with Cigna on July 11.
The biggest complaint Lopez heard: providers unable to get through on the phone to Cigna.
"They were anticipating around 3,500 calls per day," said Lopez. "It shot up shortly after the transfer to about 29,000 calls."
For providers in Virginia and West Virginia, the transition was rockier. On June 1, the two states moved from Jurisdiction B to Jurisdiction C and many have seen payments held up.
"We got transferred OK as far as the billing," said Sam Clay, president of Petersburg, Va.-based Clay Home Medical. "But we've been having to get payment by mail instead of electronically."
Even providers who switched from Jurisdiction B to C early found themselves having trouble.
"We jumped on early so we wouldn't get caught in the middle of the rush," said Sheila Pitzer, director of client accounts for Winchester, Va.-based Valley Home Medical. She said her electronic payments came to a "grinding halt."
"They lost our applications in the beginning," said Pitzer. "It took weeks to figure out what the problem was."
Some providers in Virginia received paper checks without EOBs, said Stephanie Hess, secretary and regulatory co-chair for the Virginia Association of Durable Medical Equipment Companies.
"Somehow, their provider number is tying into Florida providers and their EOBs are going to Florida," said Hess. "They don't know where to post their payments."