News

Cost of Care Estimator Added to CIGNA Website

A new feature on CIGNA's website allows providers to estimate out-of-pocket costs for patients with coverage through CIGNA.

Currently the feature can be used for professional and outpatient services.  The target date for adding capability for inpatient services is Oct. 20, 2009.

Accessible through CIGNA's secure website, providers generate an Explanation of Estimate online by entering the following information:

• up to 10 CPT or HCPCS codes,
• anticipated place, type and date of service, and
• the patient's date of birth and member ID.

The estimate will show:

• total cost,
• how benefits will be applied, based on plan design and plan-year deductibles, and
• remaining amounts that will be the patient's responsibility. 

Estimates are based on the provider's most recent 12 months of claim activity, including adjustments, for the procedures or services being considered.  When applicable, multiple procedure guidelines will be applied.  If claim data is not available, the estimate is based on regional averages.

The estimator is designed to facilitate discussions of payment options, including collecting up to half of the estimated out-of-pocket amount from the patient before treatment is provided.

If you do not currently have an account for access to the secure sections on CIGNA's website, including the care estimator feature, register for an account.