05/01/2017

Cigna-Billing for X-Rays

Notified by Cigna that they in tri-state area non radiologists providers cannot bill for xrays . Must give a prescription to an in network facility. We can bill patient prior to treatment but cannot bill after receiving EOB. They must be informed in writing prior to taking xrays.

The notification from Cigna is correct. Depending on the provider’s location within the tri-state area, there are two third party contractors that work with Cigna to process any radiology or therapy claims:

• American Imaging Management
• Orthonet

A podiatrist participating with Cigna can attempt to enroll with either of the third party vendors so radiology services can be billed without referring the patient to an outpatient radiology facility. If a podiatrist is not contracted with either vendor at the time of service, the patient will have to be notified that they will be responsible for payment if they do not follow plan guidelines by going to an in-network radiology provider.