For direct contracting information or FAQs, refer to the IPN Transition section of IPN's website.

IPN will continue to handle credentialing applications for new providers, as well as recredentialing and demographic updates for existing providers, submitted on or before June 30, 2022. Such information will be reported to all payors found on the IPN Client List. Credentialing and recredentialing applications, as well as other demographic changes, submitted for July 1, 2022 or later, will only be used for participation with PacificSource Health Plans.

This means providers should continue to report all adds, changes and terminations to IPN and complete any other documentation, including recredentialing requests, sent by IPN or IPN payors. Failure to report updates and/or complete such documentation may result in termination from the network and participation with payors.

NOTE: Separate contracting, credentialing, recredentialing and/or other demographic documentation may be required by payors in order to support any direct agreement. This includes, but is not limited to Cigna, CorVel, Health Net Federal Services, PacificSource Health Plans and Moda. To learn more about the IPN Transition, or direct contracts visit www.ipnmd.com/Providers/Newsletters/.

For news, tools, and key resources, visit Pacificsource.com/providers/medical.

Facility-to-facility transfer authorization waiver: Cigna currently waives the authorization requirement for direct emergent or urgent transfers from an acute inpatient facility to a second acute inpatient facility, skilled nursing facility, acute rehabilitation facility, or long-term acute care hospital for Cigna commercial and Cigna Medicare Advantage lines of business. As previously communicated, this accommodation will end on March 31. Therefore, effective with patient transfers on and after April 1, authorizations will again be required for all lines of business.

Credentialing accommodations: Credentialing accommodations, which were previously set to expire on March 31, have been extended through April 30 and will be evaluated on a monthly basis. Accommodations that are extended include: implementing an accelerated credentialing process and allowing Cigna-participating commercial and behavioral health providers (who have up-to-date credentialing) to provide in-person or virtual care in other states to the extent that the scope of the license and state regulations allow such care to take place. Providers can request additional states be loaded through the normal credentialing submission process and will not need additional credentialing.

Virtual care: Effective for dates of service of March 13 and later, Cigna no longer reimburses virtual care services provided by urgent care centers when billed with a global S9083 code. Virtual care services rendered by urgent care centers (and other brick-and-mortar providers) remain reimbursable when covered and billed consistent with the R31 Virtual Care Reimbursement Policy (e.g., must bill codes on the list of covered services and be contracted to provide those services).

For more information, visit Cigna.com > Health Care Providers > Billing information and resources related to the COVID-19 pandemic.

Click here to read the revised Cigna Reference Guide for participating physicians, hospitals, ancillaries, and other health care professionals.

eviCore healthcare (eviCore) administers the precertification program for Cigna commercial customers who use oncology drugs on an outpatient basis during cancer treatment. As part of this program, providers are required to request precertification for pharmacy oncology drugs and medical oncology medications, including primary chemotherapy and supportive drugs. During the precertification process, eviCore reviews the entire treatment plan for consistency with the National Comprehensive Cancer Network® Clinical Practice Guidelines in Oncology for categories 1, 2A, and 2B recommendations. An updated quick reference guide is now available.

Cigna routinely reviews coverage, reimbursement, and administrative policies for potential updates. In that review, consideration is taken of one or more of the following: Evidence-based medicine, professional society recommendations, Centers for Medicare & Medicaid Services guidance, industry standards, and other existing policies.

As a result of a recent review, Cigna will update the processing for facility claims for supplies submitted with Healthcare Common Procedure Coding System (HCPCS) codes C1052, C2615, C9359, C9362, and T5999. Effective for claims processed on or after June 11, 2022, Cigna will expand the existing reimbursement policy, Facility Routine Services, Supplies and Equipment – (R12), to administratively deny claims submitted with these codes. Reimbursement for these supplies is included in the facility payment. Denials will include administrative appeal rights.

For more information about reimbursement policies, log in to the Cigna for Health Care Professionals website (CignaforHCP.com) > Resources > Reimbursement and Payment Policies > Reimbursement and Modifier Policies > Reimbursement Policies.

www.ipnmd.com