July 2021
Provider eConnection
IPN News and Events
that you don't want to miss!
CIGNA MOVING TO DIRECT CONTRACTING
As was announced earlier, Cigna will term the relationship with IPN on June 30, 2022. Cigna has begun contacting some IPN providers regarding this effort and will, eventually, establish a Cigna network in Idaho.

Please be patient as Cigna develops a contracting team. Each office will be contacted in plenty of time to expect a smooth transition for Cigna patients.
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RUN-OUT REPRICING
Click here to see a list of terminated groups for which IPN is processing run-out claims. Be sure to submit claims before the run-out period ends!

For additional information about the terminated groups, contact the payor listed on the patient's ID card.
Payor News
PACIFICSOURCE COMMUNICATION UPDATES

COVID-19
Read FAQs related to Benefit and Reimbursement Policies: Benefit and Reimbursement Policy.

General Information
For news, tools, and key resources, visit pacificsource.com/ providers/medical.

CIGNA COMMUNICATION UPDATES

COVID-19
Read Cigna's interim billing guidelines and FAQs here.

Modifier 26 Reimbursement Update
As previously communicated, Cigna planned to implement a change to the administration of reimbursement policy for Current Procedural Terminology (CPT®) codes billed with modifier 26 effective July 10, 2021. After additional review, Cigna decided to delay implementation of Modifier 26 (M26) – Professional Component reimbursement policy update.

The update will no longer be effective July 10, 2021 as originally planned. Cigna will continue to consider the feedback received from providers as the policy update is reevaluated. Cigna will communicate the new implementation date 90 days in advance once a new date has been determined.

Specialty Medical Injectables with Reimbursement Restriction
Effective, July 1, Cigna will expand the Specialty Medical Injectables with Reimbursement Restriction list to include EXONDYS 51 (eteplirsen) and VILTEPSO® (viltolarsen). Guidelines state that certain injectables must be dispensed, and claims submitted, by a Cigna-contracted specialty pharmacy, unless otherwise authorized by Cigna.

The reimbursement restriction list:

  • Applies when the specialty medical injectable is administered in an outpatient hospital setting.
  • Applies to specialty medical injectables covered under the customer’s medical benefit. Coverage is determined by the customer’s benefit plan.
  • Does not apply when the specialty medical injectable is administered in a provider’s office, non-hospital-affiliated ambulatory infusion suite, or home setting.

*Cigna may grant approval for coverage of an initial dose to a facility when medical necessity is met to allow arrangements to obtain the drug from a Cigna-contracted specialty pharmacy.
Just for Fun
Interesting 4th of July facts:

  • The Liberty Bell rings 13 times every Independence Day to honor the 13 original states.
  • The very first 4th of July fireworks show took place in Philadelphia in 1777.
  • The 4th of July didn’t become a federal holiday until 1870.
  • Three presidents who signed the Declaration of Independence died on July 4th: John Adams and Thomas Jefferson both died on July 4, 1826 on the 50th anniversary of the country’s independence. James Monroe died five years later on July 4, 1831.

"With freedom comes responsibility." -Eleanor Roosevelt
Contact IPN
www.ipnmd.com
p: 866.476.1076 | f: 208.433.4605 | e: ipn@ipnmd.com