Attention CIGNA Health Insurance Holders
Posted: Mar. 14, 2018
As of February 15, 2018, South Nassau Communities Hospital is no longer a participating provider in the CIGNA network due to an inability to reach agreement on fair and equitable reimbursement rates
South Nassau’s costs to provide the quality care that you expect continue to escalate and CIGNA has proposed reimbursement rates that cannot support our commitment to excellence.
This dispute is about the amount of money CIGNA should provide for services the hospital renders to patients, not about the quality of care provided at South Nassau.
What does this mean for you, as a CIGNA Health Insurance Holder who uses South Nassau Communities Hospital?
- Emergency Department visits and urgent/emergent admissions will be handled as in-network. This means that under these circumstances, your member claims will be handled as in-network and your (member) out-of-pocket liability will be the same as if the care was rendered at an in-network facility.
- Pregnant women in their second or third trimester will be considered eligible for the Continuity of Care provision. The form for this provision can be downloaded from www.cigna.com/assets/docs/cigna-notices-of-privacy-practices/medical-forms/toc-coc-wo-mh-eng.pdf and submitted to CIGNA. Feel free to call the prenatal registration area of the hospital at (516) 632-4792 for further assistance. Please note, any woman who presents to the hospital in active labor will have her claims handled the same as an emergency admission and the patient’s out-of-pocket liability will be limited to her in-network coverage levels.
- For elective, non-emergent treatment, check to see if your policy offers out-of-network coverage, which would allow you to utilize South Nassau Communities Hospital. Patients who are presently undergoing treatment on a recurring basis can still receive these services under the Continuity of Care provision. The patient will need to complete the Continuity of Care Request Form, which can be found in the above link. Completing and submitting this form will allow CIGNA to process your claim as in-network, meaning your out-of-pocket responsibility will be limited to your in-network levels. This applies to all services South Nassau offers at the Hospital, as well as all of the off-site treatment centers that are affiliated. You can also call the area where you are receiving services for assistance in this process.