Cigna Medicare: Fill & Download for Free

I love Medicare. 90% of my patients are 65 or older.And, where I live, at least 80% of them have Medicare as their insurance. For my own patient pool, at least 95% of everyone I see has Medicare. This is because Medicare gave me the least trouble during the credentialing process.I sent my application to be registered with Medicare.The application was acknowledged within a month.Once the application is acknowledged as received, Medicare will take your bills going back to 1 month prior to the date the application was received. For instance, if you get notified that the application was received on November 14, Medicare will pay you for your work starting on October 14.Now, it actually takes several months for the process to be completed after that. For instance, I had to wait until March to get all the money Medicare owed me. I got it all in a huge lump sum, which I threw at my student loans.I feel very well compensated for the work I do. This is by far the most money I’ve ever made. The process to get credentialed with private insurers was more painful. I can see patients who have Blue Cross Blue Shield of Tennessee. But if a patient comes in with insurance from Aetna or Cigna, and I see those patients and send bills, the insurers will refuse to pay, because I am not in their network. Okay, so I applied to get on the network. I was told that the network was “closed.” I still have to see those patients on occasion… my work goes uncompensated.Medicare is never closed, whatever that means.

I am not old enough for Medicare, but I deal with it on a regular basis with my job in Home Health Care, which is covered by Medicare. Straight Medicare A&B is always the best option. However, if you MUST get a supplemental plan here are the ones to avoid from a Home Health Care Perspective: Cigna Medicare- none of the Home Health companies accept Cigna Medicare. Occasionally you can get by with a Cigna Healthsprings but it’s rare. BCBS Medicare- this one is tough because there are only 1 or 2 that are readily accepted. The rest are usually out of network or require an exorbitant copay. Kaiser Medicare. It’s virtually impossible. You should NOT need a copay for Home Health. UHC Medicare can be difficult, but it’s easier than the others to find someone to take them.Here are the plans that give you the most bang for your buck!:MedicareHumana MedicareAetna MedicareClover Medicare (Walmart’s new supplemental)Tricare MedicareIf you are able to afford it, the best option is to get tradititional Medicare A&B, then Humana MCR or Aetna MCR or even BCBS MCR as secondary with a part D.It’s confusing, and the people selling the supplemental plans are paid commission only so they DO NOT have your best interests at heart. If you or an elderly or disabled loved one is hospitalized or ill and in need of Home Health, I’m happy to help you find a company to help you.

I don’t know if you can!Even I, as a physician, get frustrated when I see other specialists for care and I am also wondering how much will I be charged?I think the root of the problem comes back to the excessive complexity of the billing codes that are used.For example, for an office visit in a doctor’s office, there are five codes that a doctor can use, depending on how complex the visit is.For closing a wound, there are three different codes, plus location code-modifier:12013 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm12035 Repair, intermediate [complexity], wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm13150 Repair, complex [complexity], eyelids, nose, ears and/or lips; 1.0 cm or less.And you bet that each code has different reimbursement rates from different insurance companies.Therefore if your plan has a co-insurance of 20% (meaning insurance pays for 80% of the visit’s cost and the patient has to pay the rest of the cost, 20%), the amount you pay varies depending on the complexity.For the most part the doctor does not know your complexity until you arrive.Then you add to the fact that every single insurance that the doctors accept has different rates, that adds to the confusion.In L.A. where I practice, common insurance plans include Anthem BlueCross, BlueShield of California (yes, in the state of California, BlueCross and BlueShield are TWO separate insurance companies), HealthNet, Kaiser (yes, Kaiser in Southern California has contracted out some mental health services to private providers in the community), United HealthCare, Aetna, Cigna, MediCare and Medi-Cal, L.A. Care, Oscar, etc.But let us be honest. Many providers can a bit lazy to pull up from their rate sheets from each insurance plan to advise the patients on potential costs ahead of time. After all, it is not like we need the exact costs. Roughly can be good enough so we can set aside the budget.However, some providers also carve out their billing services to an outside vendor so even they are not sure how much they get paid by which insurance ahead of time.