MCAG Publishes Guide for Physicians Who Plan to Self-File CIGNA Claims
[Posted 01/27/05]

As reported in recent issues of CMA Alert, January 24 was the last day to sign up with Managed Care Advisory Group (MCAG) for filing assistance under the CIGNA RICO settlement. Although the MCAG deadline has passed, it is still possible for physicians to submit claims directly to the settlement administrator.

To help physicians through the claim-filing process, MCAG has developed a step-by-step guide for physician offices. Physicians who are able to document that their claims were improperly downcoded, bundled, or denied based on medical necessity are eligible to receive payment from the uncapped Claim Distribution Fund. Physicians should be aware that gathering and submitting the required documentation takes the typical physician practice two to three weeks. If you plan to submit claims under this fund, you should begin the process immediately. The final deadline to file all claims with the CIGNA settlement administrator is February 18. No extensions will be granted.

Class members who cannot or choose not to submit documentation for individual CIGNA claims may choose instead to receive a pro rata share of the $30 million Category A Fund. To be eligible for this fund, physicians need not have treated CIGNA patients. The class includes physicians who provided covered services between August 4, 1990, and September 5, 2003, to any patients covered by any of the defendants in this case—CIGNA, Aetna, Anthem, Coventry, Health Net, Humana, PacifiCare, Prudential, United Healthcare, and Wellpoint.

Click here to download the step-by-step guide.

Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org.