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Tuesday, 17 December 2013 11:22

On February 17, 2014, Cigna will begin using ClaimsXten version 5.02, a market-leading, rules-based software application that evaluates claims for adherence to industry-standard coding practices based mainly on Centers for Medicare & Medicaid Services (CMS) and American Medical Association (AMA) guidelines.

This clinically based code review application will replace McKesson ClaimCheck, the current code review tool.

What this means to health care professionals:

  • You can continue to use McKesson’s Clear Claim Connection tool – available through the health care professional website (CignaforHCP.com) for self-service access.
  • When using Clear Claim Connection, enhanced by ClaimsXten’s ability to apply industry-standard coding practices, you will see additional transparency and consistency in how rules, guidelines and policies are applied.
  • Several new code editing rules will go into effect.
  • The majority of the code edits that are now in ClaimCheck will continue to apply with no changes when they migrate as part of the update to ClaimsXten on February 17, 2014.

For more information about migration to ClaimsXten, including details about the code editing rules mentioned above, visit: CignaforHCP.com > Useful Links > Policies & Procedures > Claim Editing Policies & Procedures or by calling Cigna’s Customer Service at 1-800-88Cigna (882-4462).

 


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