Cigna DMGMA Annual Update Lorie Jennings-Forrester March 21, 2012

2 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna – Annual Update Cigna’s New Branding Integration News HCP Website review Cost of Care Estimator update EDI Attachments & Corrected or Secondary Claims Online Remittance Reports MedSolutions, Inc Bravo Health HIPAA-5010/ICD10 Demographic Changes Today’s Topics:

3 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna’s New Brand: Some of the changes you may have seen or will notice in the coming months: Our name Our logo ID cards Our new brand identity more closely aligns with our strategy and our mission, to help the people we serve improve their health, well-being and sense of security.

4 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna’s New Brand: Our Name: We are still Cigna, but now you’ll see that we are using both upper and lower case letters.

5 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna’s New Brand: Our Logo: We’ve changed our logo to reflect our focus on our customers (your patients) and our commitment to connect people with quality health care.

6 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna’s New Brand: Our ID Cards: The Cigna Logo has been removed The card background is now white The Cigna name now appears in upper & lower case letters

7 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Integration News The Cigna and GWH-Cigna contracts integrated 04/01/2011 Cigna Agreement and its rate schedules will apply to GWH-Cigna patients. Integrated Payor ID Separate claim and call services for your patients Separate Networks Different contractual relationships with Vendors

8 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna As part of Cigna’s enhancements to support the Version 5010 updates, we have consolidated to one Cigna payor ID (62308) *If your clearinghouse has not migrated to 5010, you will still require separate payor ID’s for GWH and Cigna. ID Old GWH-Cigna payor ID that is being integrated: ID Integration News Introducing one payor ID for claim submission

9 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Integration News Separate Call & Services Channels continue Cigna maintains separate networks for your patients with GWH-Cigna ID cards Continue to reference the ID card ID card still has GWH-Cigna listed in top right corner

10 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Integration News Once secure website coming soon We will transition to one secure website for both the Cigna and GWH-Cigna networks within the fourth quarter of 2012

11 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna eServices Cigna for Health Care Professionals Website If you provide service to customers with Cigna ID cards, access this website for: Eligibility and benefit inquiries Patient liability estimator Precertification Claim status inquiry Remittance reports View Claim Coding Edits Other resources Secured Provider Portal If you provide service to customers with GWH-Cigna ID cards, access this website for: Eligibility and benefit inquiries Precertification Claim status Claim payment and explanation View Claim Coding Edits Other resources Cigna Has Two Websites Which Are Free to Use THN Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna

12 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna eServices Enter your User ID and Password to log in to the Cigna for Health Care Professionals website ( THN Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna

13 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Resources Page Cigna reference guides Claim appeals policy Claim submission addresses and requirements Disease management programs Electronic prescription submission Pharmacy formulary Provider directory Remember to check the site often for policy and procedure updates.

14 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Enter your User ID and Password to log in to the Secured Provider Portal ( If you are not already registered to use the website, click “Register Now”. Cigna eServices THN Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna

15 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Secured Provider Portal – Home Page View important updates to plans and services Check the details of processed claims View precertification requirements Access helpful resources, including: Clinical guidelines Payment guidelines Dispute resolution Reference guides Note: Some links may redirect to cigna.comcigna.com or cignaforhcp.com

16 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cost of Care Estimator Cost estimation capability now available for patients Using a secure website, your patients with Cigna administered medical coverage can: Compare quality & outcomes measures for services Produce personalized cost estimates Research cost This new capability is an extension of our efforts to offer transparency to our customers, and help them better understand what they can expect to pay out of pocket.

17 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cost of Care Estimator - updates Estimating tool for Health Care Professionals: Now Available for more plans: HMO/Network, Open Access, PPO, POS

18 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Electronic Claims Submissions Attachments and Corrected/Secondary Claims Cigna accepts secondary claims electronically Cigna accepts corrected claims electronically Milliman Study: electronic transaction savings opportunities

19 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Online Remittance Reports View your Remittance Reports online same day Reconcile payments same day New remittance tracking number Search and download online reports Reduce the amount of paperwork you receive As of September 2, 2011, Remittance Reports are only available online

20 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Cigna and MedSolutions, Inc Effective October 1, 2011 CIGNA, including the GWH- CIGNA network has entered into an expanded relationship with MedSolutions, Inc.(MSI) to provide radiology benefit and network management services. The following services do not require utilization management review and will not be affected by this change: Inpatient high-technology radiology services Emergency Room radiology services Outpatient radiology services other than CT, MR, PET, and nuclear cardiac studies MSI will finalize claim payments for the outpatient, non-emergent high-technology radiology procedures

21 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna ABOUT HEALTHSPRING One of the nation’s largest health plans, whose primary focus is Medicare- eligible individuals HealthSpring is based in Nashville, Tennessee, and currently operates Medicare Advantage plans in the following states: AlabamaDelawareFlorida GeorgiaIllinoisMaryland MississippiNew JerseyPennsylvania TennesseeTexasWashington, D.C. West Virginia Includes a national stand-alone prescription drug plan Cigna acquired HealthSpring, Inc. and its subsidiaries, including Bravo Health, a HealthSpring company, and HealthSpring of Florida, on January 31, 2012.

22 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna There are no changes to how health care professionals interact with Cigna or HealthSpring. Continue to use existing processes and procedures for Cigna and HealthSpring. There are no changes to: WORKING TOGETHER What the acquisition means to health care professionals –Network participation – health care professionals who participated in just one network prior to the acquisition, continue to participate in only that network today –Contracts –Fee schedules –Administrative processes – Continue to use the same claim, eligibility and benefits checks, and precertification procedures that you use today –Referral procedures – Continue to refer patients to network participating physicians, facilities, and vendors –Patient ID cards –Contacts

23 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna HIPAA 5010 Frequently Asked Questions (FAQs) are available on our website ( > Resources > Communications > HIPAA 5010/ICD- 10 Updates) or call CIGNA ( ) if you have questions about the changes required or CIGNA's readiness to support the required changes. ***Companion guides are available through your clearinghouse vendor. ICD-10 The federal government, through the Centers for Medicare and Medicaid Services (CMS), is driving the health care industry to upgrade diagnosis and procedure coding standards to ICD-10 by October 1, On February 16, 2012, the Department of Health and Human Services announced the intent to delay the ICD-10 mandatory implementation date of October, 1st, Cigna will continue work on Enterprise compliance based on current project plan deliverable timelines.

24 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna COMPLIANCE TIME LINE October 1, 2013 ICD-10 Compliance ICD-10-Based Claims ICD-9-Based Claims 1.Accept ICD-9 claims for dates of service or discharge before the October 1, 2013 compliance date 2.Accept ICD-10 claims after October 1, 2013 October 1, 2012 ICD-10 External Testing Design solutions for ICD-10 ICD-9 processing Leverage ICD-10 Process ICD-10 claims and support ICD-9 runoff Dual processing (ICD-9 and ICD-10) ICD-10 processing value realized Regulatory Time Line Health plans will need to accept both ICD-9 and ICD-10 codes for several years to support claim runoff after the ICD-10 compliance date of October 1, Cigna is working towards the ICD-10 compliance date of October 1, 2013.

25 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna Please notify us in writing 90 days before changing your office or billing address, telephone number, tax identification number or specialty. Submit your demographic changes to: StateSubmission Options Connecticut, Delaware, Illinois, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, West Virginia, Wisconsin ■Phone: ■Fax: ■ Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, Virgin Islands, Washington DC ■Phone: ■Fax: ■ Alaska, Arizona, California, Colorado, Hawaii, Idaho, Kansas, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming ■Phone: ■Fax: ■ Demographic Changes THN Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna

"Cigna" is a registered service mark and the "Tree of Life" logo is a service mark of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc /11 © 2012 Cigna Questions?