Cigna Prior Authorization and Referral Requirements for Medical Practices
You scheduled the procedure. The patient showed up. The doctor did the work. Then the claim gets denied again because no one got Cigna’s approval ahead of time, or
Read More
You scheduled the procedure. The patient showed up. The doctor did the work. Then the claim gets denied again because no one got Cigna’s approval ahead of time, or
Read More
Humana may underpay you, deny you, or hold your claim for weeks. Sometimes, all three issues occur for a single patient. In response, most practices make more phone calls,
Read More
A patient hands your front desk a Kaiser card. You run it the way you’d run any other, you see the visit, and three weeks later the claim comes
Read More
A claim comes back from UnitedHealthcare with a denial code and a deadline nobody on your team noticed. Multiply that by a few dozen a week and you have
Read More
You saw the patient. The note is signed, the codes are right, and the claim went out the door. Then the remittance lands with one line: “Time limit for
Read More
Ask anyone who bills drugs without a dedicated HCPCS code, and they’ll tell you the same story. You submit under an NOC code, you wait, and half the time
Read More
You did the visit. You documented it properly. The care was medically necessary and clinically sound. And Cigna still cuts your payment. That’s the reality practices are waking up
Read More
The #1 trigger for Instant Denials The #1 trigger for Instant Denials is Missing or Inconsistent Diagnosis-to-Procedure Mapping. Meta title: Fix Diagnosis to Procedure Mapping: Stop Instant Denials. Meta
Read More
If you bill Cigna for office visits, mark your calendar. Starting October 1, 2025, Cigna is rolling out a new reimbursement rule that lets the payer quietly cut your
Read More
Starting December 1, 2025, UnitedHealthcare is denying more lab claims before they are ever paid. The insurer’s new Routine Laboratory Testing Policies add automated frequency limits, diagnosis-to-test alignment checks,
Read More