March 2020 Provider eConnection
news for IPN Provider Offices
Provider Orientation Webinar | Is Your Practitioner Hospital Based? | Claim Corner |
Run-Out Repricing | Cigna Communication Update | Direct Care Administrators Update | Training in Secondary Traumatic Stress (STS)
Provider Orientation Webinar
Please join IPN's Credentialing and Provider Representatives on March 11th at 12pm MST to learn about credentialing application requirements, provider tools and resources, claim assistance, and how to navigate our website.
to sign up!
Is Your Practitioner Hospital Based?
If a clinic based practitioner performs rounding duties at a hospital for the benefit of a patient, the practitioner is not considered Hospital Based.
For a practitioner to be Hospital Based, the following must apply:
- Licensure is MD, DO, NP, PA, CRNA or CNS,
- Health care services provided within an IPN-credentialed hospital,
- Privileges granted by the hospital,
- Appointments not accepted for services at the hospital, and
- Patients have been directed to, or present at, the hospital for health care services.
Credentialing of a Hospital Based practitioner is delegated to the participating hospital and IPN is not required to perform the credentialing duties.
, if the practitioner provides health care service in a clinic setting or any
facility owned by a hospital, IPN is required to credential the practitioner.
Please contact IPN Customer Service at 208-333-1513, toll free 866-476-1076 or email@example.com before submitting practitioner data as Hospital Based if any qualification is in question.
To ensure claims are properly handed by IPN's repricing vendor -
1. Verify the employer group is listed on the IPN Payor List or the Run Out Repricing button below. If not, the group may not belong to IPN. Please contact the payor to obtain accurate claim submission information.
The IPN Payor List can be found in the secure section of the IPN website under Providers>Payor List. To register for secure access, click
2. Enter the insured's policy group number in box 62 (UB) or box 11 (HCFA) of the claim form. Claims with invalid or missing group numbers will be returned to providers for appropriate submission. The only exception is for Cigna and PacificSource who do not require the policy group number to be submitted for processing.
IPN is providing run-out repricing for some terminated groups. Click the button below for a list of those affected.
For more information related to these terminated groups, please contact the payor's customer service representative at the phone number located on the insured's identification card.
Cigna Communication Update
Q1 2020 Network News
The first quarter 2020
has been released by Cigna. Click
to read about recent Policy Updates, Electronic Tools, General News and more!
Genetic Testing Panels Reimbursement
Effective for claims processed on or after April 6, 2020, Cigna will rebundle
Current Procedural Terminology (CPT®) codes used to bill for individual tests that comprise a molecular cancer laboratory cancer panel into a single panel code. Submitted claims will be processed and reimbursed using the appropriate CPT panel code. Cigna will also no longer require precertification for certain CPT codes for individual tests. An article about the update will be included in the April 2020
Serum Drug Level Testing for IBD
Effective for claims processed on or after April 15, 2020, Cigna will deny Current Procedural Terminology (CPT®) codes for serum drug level testing when billed with an inflammatory bowel disease (IBD) diagnosis. Serum drug level testing for IBD testing is considered experimental, investigational, and unproven (EIU).
The medical coverage policy for Serological Testing for Inflammatory Bowel Disease (0121) will be updated to reflect this change and a
n article about the update will be included in the Q2 2020
Direct Care Administrators Update
Direct Care Administrators began partnering with
Change Healthcare and
ECHO Health Inc to provide new electronic payment method options to providers.
As of February, IPN participating providers who are not set up to receive
payments electronically will begin receiving Virtual Credit Card payments with Explanation of Payments (EOP). Instructions on how to process the payment will be included, but please note: transaction fees may apply. If providers do not wish to receive
the Virtual Credit Card but would like to receive payments electronically, other options include
EFT Payments or enrollment in MedPay. If providers do not wish to receive the Virtual Credit Card OR any electronic payment, refer to the Opt Out process provided in the EOP.
Review payment options and any actions needed by your office
Training in Secondary Traumatic Stress (STS)
Participating IPN providers, Brian Huck, LCSW & Bryant Kusy, LCPC (
) are sharing their more than 30 years of experience to provide Consultative Guidance to help organizations "better see and manage Secondary Traumatic Stress" (STS) among providers. Training date(s), time(s) and location(s) would depend on interest level. See the
brochure for more information.
Frankie Campbell (Specialist)
Jennifer Ford (Specialist)
Julie McCann (Manager)
Meagan Meter (Coordinator)
Samantha Adams (Specialist)
Stefani Borja (Specialist)
Contracting & Relations
Amy Campbell (Provider Contract Representative)
Megan Smith (Senior Payor Representative)
Michelle Ridlon (Senior Provider Services Representative)
Allyssa Wood (Data Support Specialist)
Barb Morris (Manager)
Codi Tomisser (Team Lead)
Kyler Jackson (Customer Service)
Leona Campbell (Data Support Specialist II)
(P) 208-333-1513 or 866-476-1076 | (F) 208-433-4605
IPN Board of Directors
April Dillion, DO;
Daniel Reed, MD;
Edward McEachern, MD - PacificSource HP Executive VP and CMO; Gary Wallace, MD (President); Graham Wetherley, MD (Vice President);
Hilary Klarc - IPN Executive Director;
Jeffrey Hessing, MD;
Jeremy Waters, MD;
Joseph Williams, MD;
Martin Gabica, MD;
Matt Bell - PacificSource HP VP & Idaho Regional Director; and
Peter Davidson - PacificSource HP CFO