Pre-Certification Issues

Practice Resources
Cigna (through eviCore) has implemented a pre-certification process for total joint arthroplasty patients. AAHKS President Jay R. Lieberman MD, and AAHKS Executive Director Michael J. Zarski, JD met with the leadership of Cigna and eviCore to review concerns with this process. The AAOS also had representatives at the meeting. AAHKS and AAOS expressed concerns with a number of procedural and clinical aspects of the pre-certification process. At that meeting, it was agreed there would be a follow-up conference call to address any problems encountered with the pre-cert process after the official roll-out.

If your staff has problems getting cases approved in a timely fashion, it is essential that that you make this clear to eviCore and Cigna. It is also essential that you inform AAHKS about your experience with the Cigna precertification program both good and bad, but especially denials or delays in authorization. AAHKS will then review this data with Cigna in late February or early March.

Please contact Josh Kerr, Director of Advocacy and International Activities, at AAHKS about your experience with Cigna or if you have any questions regarding this process at jkerr@aahks.org or (847) 698-1200.

To access the Cigna/EviCore approval process, visit https://myportal.medsolutions.com or call 888-693-3297.

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