New: Get immediate code edit audit results with Clear Claim Connection™ via HSConnect

Improve claim accuracy by identifying potential errors in advance. Simply enter Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes into Clear Claim Connection to immediately view audit results. You can access the Clear Claim Connection code edit audit tool from your dashboard on HSConnect.

Please refer to the link below for PHE updates on changes to authorization requirements.

https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspxt

HSConnect Enhancements

The following enhancements were released in February and March 2022 for providers in all markets, except Arizona. Please note, all users may not have access to some claims features.

• Ability to view patient demographic information on the Authorization Details screen including patient first name, last name, ID number, and date of birth
• Ability to print authorization details to hand to the patient
• Improved ability to search claims by patient
• Claims search screen expansion and improvements
• Ability to view in-depth patient information (e.g., copay, coinsurance, deductibles, etc.) in the details of the claim for claims submitted after February 3rd, 2022.

HSConnect Provider Portal User’s Guide

The HSConnect Portal Enhancement Resource Guide is your comprehensive source for information about the portal, including answers to frequently asked questions, and where to find additional resources and support.

To open the guide, click on the appropriate link below.

• Arizona providers
• Providers in all other states

Training for new users

To receive your login credentials, you must complete the Provider Portal Enhancement General Functionality module. We also encourage you to review the following training modules:

• Prior Authorizations: Outpatient Medical,
• Prior Authorizations: Behavioral Health Outpatient,  
• Prior Authorizations: Drugs and Biologics Part B,
• Prior Authorizations: Inpatient Precert(procedures),
• Prior Authorizations: Inpatient Medical / Inpatient Review(admissions)
• Prior Authorizations: Behavioral Health Inpatient

Prior authorization requirements and forms

As a reminder, you can find prior authorization requirements and forms on the Cigna Medicare Advantage website for providers. Go to MedicareProviders.Cigna.com > Find a Form. 

Support for providers

As of June 30, 2021- eviCore will process pre-certification requests for procedure codes related to musculoskeletal pain and joint management for Medicare Advantage plans with some exclusions. Requests may be entered directly at eviCore.com.