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Cigna Cultural Competency

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Creating value through collaboration has been a topic of concern over the last 50 years as the spending in health care has increased. The goal is to provide quality and affordability and because of past efforts, enrollment increased drastically while it created a shortage of providers.
Integrating behavioral and medical health has not been properly addressed due to stigmas and lack of education. Behavior health is more common today and costly. In efforts to integrate and improve patient outcomes and provider experiences there are many ways to achieve this goal such as train medical providers, train behavioral practioniers and embed behavioral providers in primary care settings. Cigna’s approach can help promote behavioral awareness and respond …show more content…

More companies are expanding sites for their employees insuring high quality care, saving them time and travel costs. This will be a convenience for employees as it will not require them to take extra time off work. Cigna wants employers to achieve a healthier workforce and provide a wide range of services that will meet the needs of individuals.
Cultural Competency in Health Care wants to focus on delivering quality care to diverse populations. With the population continuing to increase, Cigna wants to incorporate existing barriers in understanding ways to improve a healthy outcome. Cultural competency is the mission to ensure that all members will have a personalized experience when receiving care.
Cigna reimbursement policies and procedures include electronic transfer funds (ETF), electronic remittance advice (ERA), medical supplies, multiple procedures and overpayment recovery procedures. Electronic transfer funds (ETF) are payments made direct into your bank account providing quick service, accurate payments and security of your accounts. Enrollment takes about 4-6 weeks and verification is needed for other account …show more content…

Enrolled health care providers receive lower costs, time savings, fewer errors and shorter payment cycles. In order to receive ERA’s you must request the Cigna registration form using your Electronic Data Interchange (EDI) vendor and Post-n-Track. Once you completed and submit the form, registration can take up to 10 business day of receipt. Post-n-Track is available at no cost to health care professionals of Cigna.
Consumable medical supplies are covered in agreement with inpatient, outpatient, home health, diabetic and breast construction and breast prostheses services. Consumable medical supplies are non-durable medical supplies that are disposable, cannot withstand repeated use, used to serve a medical purpose, not useful to a person in the absence of illness or injury and may be order or prescribed by a physician. The reimbursement policy for medical supplies should be billed using the accurate codes. Managed Care Guidelines are listed to determine which supplies are and are not covered by

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Initially, facilities voluntarily used HCPCS codes, but with the implementation of HIPAA in 1996, facilities began to report HCPCS for transaction codes (Webb, 2012). CPT (Current Procedural Terminology) is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations (Rouse, 2015). The HCPCS level II coding system has a selected standard coding system with a wide acceptance among both public and private insurers. The HCPCS level II codes set are alphanumeric code set and primarily include non-physician products, supplies, and procedures not included in CPT. For HCPCS to bill the and identify the service that are been used such as.

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After taking the self-assessment survey for quality and culture, I would like to improve and understand how cultural competence can have a real impact on clinical outcomes. Taking from some of the questions I answered wrong, it make me wants to be cultural competent. There are a few questions I am surprised and shocked, that I answered them incorrectly. I do understand that with training, I will start to gain cultural competence but it will take consistent individual practice on my part to develop and maintain individual cultural competence. Cultural competence can lead to, health literacy, health equity, and fewer diagnostic errors, which might help the patient expand their choices and access high quality medical providers because patient

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A rising number of hospitals throughout the U.S. are applying a service model known as integrated health care (Kathol, Perez, Cohen 2010). The need for this is center around this area: Integration has made its approach into the health care settings gradually. This can assist in treating one’s medical and behavioral health needs within patient’s primary care provider’s office, recommending a proper evaluation as a whole person (Blout, 2003). Medical clinics have been used for a many years but its recognition is growing nationwide because of its effectiveness. Impact all parties involved, including but not limited to, patients, providers and insurance companies can be very effective.

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Clinicians need to see organizational leaders using evidence in their own practice and promoting clinical staff to do so also. When people in organizational leadership roles “walk the talk,” it sends a positive message about the importance and value of EBP. Highlighting successful practice initiatives that resulted from EBP is another motivational technique. Healthcare practitioners want to make the best clinical decisions to promote the best patient outcomes and will value knowing of their colleagues’ accomplishments. Education is not sufficient to embed EBP into the practice environment.

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