Radiology societies ‘alarmed’ by administrative burden, prices posed by new Cigna coverage

Cigna didn’t instantly reply to a Radiology Enterprise request for touch upon Wednesday. Physicians mentioned the insurer has contended that the aim of the coverage is to restrict the inappropriate use of modifier 25. Nonetheless, the teams mentioned that Cigna has introduced zero proof that is issues warrants correction.

“Cigna has not supplied knowledge demonstrating unexpectedly excessive use of the modifier or particulars of the underlying rationale, apart from indicating it resulted from a overview of ‘protection, reimbursement, and administrative insurance policies for potential updates’ and in consideration of ‘evidence-based drugs, skilled society suggestions, Facilities for Medicare & Medicaid Providers steerage, business requirements, and/(or) … different current insurance policies,” the doctor associations wrote.

Radiology commerce teams are asking Cigna to “instantly rescind” the coverage and work with medical docs on a marketing campaign to make sure correct documentation. They listed a number of different points with the coverage, together with attainable HIPAA noncompliance and “suboptimal” knowledge submission strategies.

“All of those considerations underscore that Cigna’s coverage is extraordinarily ill-timed and can additional hamper healthcare professionals already grappling with clinician burnout, workforce shortages, restoration from the COVID-19 public well being emergency, and rising apply bills as a result of inflation,” they wrote. “We welcome the possibility to collaborate with Cigna on different approaches to making sure appropriate utilization of modifier 25 that don’t unfairly punish the vast majority of physicians and different healthcare professionals that appropriately code, in addition to tax Cigna’s administrative methods,” the letter writers added later.

Others signing the message included the American Medical Affiliation, the American Society for Radiation Oncology and the American Society of Nuclear Cardiology. The AMA additionally shared a news update in regards to the coverage on Tuesday, April 25.