Health Care Providers

Cigna CarePlan (Medicare-Medicaid Plan)

As of January 1, 2022, Cigna has transferred the Texas Medicaid business to Molina Healthcare, Inc.

View frequently asked questions regarding this update.

90-Day Notice of EVV Compliance for State-Required Personal Care Services Providers

Home Health Care Services Required to Use EVV by January 1, 2023

EVV Contact Information Update

EVV Policy training for CDS employers now available in Spanish

Temporary EVV Policies for the February 2021 Severe Winter Weather

EVV Portal Improvements and Training Updates - February 2021

Electronic Visit Verification (EVV) 180 Day & 90 Day Visit Maintenance Temporary Policy (New)

EVV Policy Update: 180 Day & 90 Day Visit Maintenance Temporary Policy

EVV Compliance Oversight Reviews Delayed for EVV Usage & Misuse of EVV Reason Codes

EVV TAC Rules

Guidance Related to DataLogic/Vesta EVV System Outage in December 2020

EVV Portal Improvements and Training Updates - January 2021

EVV Policy Updates - Effective December 1, 2020

Health and Human Services Commission Electronic Visit Verification Reason Codes Policy (Revised) - Effective December 1, 2020

Health and Human Services Commission Electronic Visit Verification Reports Policy (Revised) - Effective December 1, 2020

Existing EVV Users: Temporary EVV Policies for COVID-19 to End December 31, 2020

EVV Dispute Form

Temporary EVV Policies for COVID-19 to end December 31, 2020

Electronic Verification Methods Policy - Effective November 1, 2020

EVV Policy Updates - Effective November 1, 2020

EVV Portal Improvements and Training Updates

EVV Proprietary System Updates

New and Revised EVV Policies - Effective October 1, 2020

Updated EVV Service Bill Codes Table - Effective October 1, 2020

Existing EVV Users: Best Practices for Temporary EVV Policies for COVID-19 - Effective October 1, 2020

EVV Claims Matching Policy - Effective October 1, 2020

EVV Claims Submission Policy - Effective October 1, 2020

EVV Visit Transaction Rejection Errors Guide Now Available

EVV Portal and TexMedConnect Improvements and Training Updates Available

Existing EVV Users: Temporary Policies for COVID-19 Extended to Oct. 23, 2020

Electronic Visit Verification (EVV) Guidance for FMSAs and Notice for Consumer Directed Services (CDS) Employers

Electronic Visit Verification Notice for Consumer Directed Services Employers

TMHP EVV Portal Improvements

EVV Practice Period by June 11

New Approval Process for EVV Proprietary Systems by May 28

EVV Portal Improvements Now Available

Existing EVV Users: Temporary Policies for COVID-19

EVV Training Sessions March 12-13 in Austin for Current Program Providers

Health and Human Services Commission (HHSC) Electronic Visit Verification (EVV) Last Visit Maintenance Date Policy (New) Effective Jan. 1, 2020

Health and Human Services Commission Electronic Visit Verification Proprietary Systems Policy

Due April 1, 2020: Program Providers and FMSAs Must Select an EVV Vendor or EVV Proprietary System

Due April 1: Select an EVV Vendor System or EVV Proprietary System

February 1, 2020 Updates to EVV Portal Standard Reports and TexMedConnect

New EVV Proprietary System Onboarding Documents Now Available

Financial Management Services Agencies Webinar Training

Announcement of EVV Vendors

Visit Maintenance Extension

Updates to STAR+PLUS LTSS Billing Matrix and Authorizations

EVV Claim Match Result Code Tip Sheet

HHSC’s Request to Delay Jan. 1, 2020 EVV Start Date is Approved

HHSC EVV Visit Maintenance Unlock Request Form - effective September 1, 2019

HHSC EVV Visit Maintenance Unlock Request Policy - effective September 1, 2019

EVV Allowable Phone Identification Policy - effective September 1, 2019

EVV Billing Policy - effective September 1, 2019

EVV Compliance Oversight Reviews Policy - effective September 1, 2019

EVV Data Elements Policy - effective September 1, 2019

EVV Reason Code and Required Free Text Policy - effective September 1, 2019

EVV Standard Reports Policy - effective September 1, 2019

EVV Training Policy - effective September 1, 2019

EVV Usage Policy - effective September 1, 2019

EVV Vendor Selection Policy - effective September 1, 2019

EVV Vendor Transfer Policy - effective September 1, 2019

Upcoming Webinars for EVV

LTSS Code Changes – effective September 1, 2019

HHSC EVV Visit Maintenance Unlock Request Policy

EVV Contact Information Matrix

EVV Claims Submission for MCO Providers – effective September 1, 2019

Changes to EVV Vendor System

EVV Upfront Processing Training

2020 MCO PIP Topics

HHSC EVV Live Webinar  - April 22, 2019

HHSC EVV Live Webinar  - March 22, 2019

EVV Mobile Application Policy - effective April 1, 2019

New EVV Provider Data Validation Process

EVV Billing Changes

Reminder EVV Visit Maintenance of MEDsys Historical Data

EVV Tool Kit Modules

EVV Visit Maintenance of MEDsys Historical Data

Read-only Access to EVV Data for Providers Not Active with an Approved EVV Vendor

Medicaid providers who were required to use EVV and who are not active with a current HHSC state approved EVV Vendor can request 30 days of read-only access to their historical EVV visit data by completing the EVV Data Access Request Form .

IMPORTANT: LTSS Atypical Provider Identifier (API) Reenrollment - Deadline February 1, 2019

Accessing Historical EVV Records Held by Sandata

Unaffiliated Third Party Regarding EVV

Potential Evaluation of Increasing EVV Vendor Pool

Proprietary EVV System Survey for Providers

Final Reminder to Transitioning EVV Providers

Access to MEDsys Data

MCO LTSS Quick Tips

Reminder to EVV Providers Transitioning to DataLogic

21st Century Cures Act & Electronic Visit Verification

EVV Providers Transitioning to DataLogic

Notice of Billing Policy Changes to Providers Required to Use EVV

EVV Revises Unallowable Phone ID & Recoupment Policy

Transitioning Providers: EVV Claims May Be Denied or Recouped

EVV Failed to Export Report Notification

Transitioning Providers FAQs and Reminder Instructions

EVV Electronic Authorization Pilot

Important Revision to MEDsys-Issued SAD Return Policy

Visit Maintenance Reduction Solutions

EVV Transition Timeline

Temporary Reduction to EVV Compliance Plan – Updated

EVV Recoupment Reconsideration:

CHS EVV Visit Maintenance Unlock Guidance

EVV Visit Maintenance Unlock Request Form

STAR+PLUS HSConnect Information

HSConnect Provider Portal - Click here to get connected and obtain access.

STAR+PLUS and CarePlan (MMP) Provider Directory and Search

Searchable Provider Directory - Cigna works with many Primary Care Providers (PCP), specialists and hospitals to meet our Member’s health care needs. With this tool, they can find health care providers in their area.

To download a Provider Directory, please click here.

Provider Complaints and Appeals

Provider Complaints to Cigna

Provider Complaints can be filed verbally, in writing or through our Provider Portal by contacting Cigna as follows:

Cigna Appeals & Complaints Department Cigna Provider Services Department Cigna Provider Portal
PO Box 23269
Nashville, TN 37202
Fax: 1 (877) 809-0783
Email:
providerrelationscentral@healthspring.com
8:00 am to 5:00 pm CST Monday to Friday
1 (877) 653-0331
Email:
providerrelationscentral@healthspring.com

Log into HSConnect:
https://starplus.hsconnectonline.com/login.aspx

If a provider complaint is received verbally, Cigna’s Provider Services Representatives collect detailed information about the complaint and route the complaint electronically to the Appeals and Complaint Department for handling. Within five (5) business days from receipt of a complaint, Cigna will send an acknowledgement letter to the provider. Cigna will resolve the complaint within thirty (30) days from the date the complaint was received by Cigna. An email can also be sent to the HHSC State Inbox: HPM_Complaints@hhsc.state.tx.us

Provider Claims Appeals to Cigna

Providers must request Claim Appeals within 120 days from the date of remittance of the Explanation of Payment (EOP).

Providers may fax written Claims Appeals to 1 (877) 809-0783 or mail them to:

Cigna Appeals & Complaints Department
PO Box 23269
Nashville, TN 37202
Email: providerrelationscentral@healthspring.com

An acknowledgement letter is sent within five (5) business days of receiving a provider’s written Claim Appeal. In the event that Cigna requires additional information to process an appeal, the provider must return requested information within twenty-one (21) days from the date of Cigna's request. If the requested information is not received within this time, the case will be closed. Provider Claim Appeals are resolved within thirty (30) days of receipt of the Claim Appeal. Cigna sends written notification of the resolution to the provider.