CIGNA Compliance NewsPhysicians Can Resubmit Previously Denied CAD Mammography Claims Physicians may now resubmit previously denied CAD mammography claims to CIGNA. This opportunity to resubmit claims is another victory resulting from the settlements in the national MDL action lawsuits against the nation's health plans. A number of State Medical Societies working under the auspices of the Physician Advocacy Institute (PAI) used the formal compliance dispute resolution process that was part of the CIGNA Settlement Agreement to require CIGNA to pay these claims.
Eligible claims must:
- Involve CPT Codes 76082 or 76083 as add-on codes with 76090, 76091, or 76092 and
- Have been submitted between January 1, 2004, when the CAD Mammography add-on codes became effective, and October 10, 2004, when CIGNA began paying the claims.
Resubmitting claims is easy. Simply complete the spreadsheet below. Completed spreadsheets should be e-mailed to CADMammoRebsubmit@CIGNA.com. Questions may also be e-mailed to this address.
Physicians without access to e-mail can mail their completed spreadsheets to CIGNA R&R Department P&C, P.O. Box 9018, Sherman, TX75091-9018 and can direct questions to the CIGNA Compliance Dispute Facilitator, Deborah Winegard, at (404) 881-8900.
Claims may be resubmitted starting June 1, 2007. The deadline is December 1, 2007.
Any physician who believes that Aetna, CIGNA, HealthNet, Humana or Anthem/Wellpoint, are violating the terms of their settlement agreements should contact the Compliance Dispute Facilitator for the settlement agreement. These facilitators are listed under each settlement agreement.
Download the CAD Resubmit Form (Excel File) | 
