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The provider is not, however, prohibited from collecting copayments, coinsurances or deductibles for covered services in accordance with the terms of the applicable customer’s Benefit Plan.
When a customer joins a Cigna-Health Spring Medicare Advantage plan, the customer agrees to give Cigna-Health Spring access to Protected Health Information.Customers can also call the Office for Civil Rights at 1-800-368-1019 or TTY/TDD 1-800-537-7697, or the Office for Civil Rights in their area for assistance.The right to the privacy of medical records and personal health information There are federal and state laws that protect the privacy of customer medical records and personal health information.There are exceptions allowed or required by law, such as releasing health information to government agencies that are checking on quality of care.The laws that protect customer privacy give them rights related to accessing information and controlling how their health information is used.Medical records and claims are generally used to review treatment and to conduct quality assurance activities but they also allow Cigna-Health Spring to look at how care is delivered and carry out programs to improve the quality of care Cigna-Health Spring’s customers receive.
This information also helps Cigna -Health Spring manage the treatment of diseases to improve our customers’ quality of life.Customers have a limit on the amount they will be required to pay out-of-pocket each year for medical services which are covered under Medicare Part A and Part B.Once the MOOP expense has been reached, the customer is no longer responsible for any out-of- pocket expenses, including any cost shares, for the remainder of the year for covered Part A and Part B services (excluding the customer’s Medicare Part B premium and Cigna-Health Spring plan premium).The provider must then contact CMS Eligibility to determine the customer’s actual benefit coverage for the date of service in question.How to Verify Customer Eligibility You can verify customer eligibility the following ways: You must call the Health Plan to verify eligibility when the customer cannot present identification or does not appear on your monthly eligibility list.If customers need help with communication, such as help from a language interpreter, they should be directed to call Customer Service.