Cigna Expands Zelis/Maverest Network Access: Impact on Dental and Medical Claims
Cigna has expanded its leasing arrangement with Zelis Healthcare, now including additional dental and medical procedures under the repricing umbrella. Practices with direct Cigna contracts should audit recent EOBs for unexpected network repricing.
What's Changing
Cigna has expanded its leasing arrangement with Zelis Healthcare, now including additional dental and medical procedures under the repricing umbrella. Practices with direct Cigna contracts should audit recent EOBs for unexpected network repricing.
This development represents a significant shift in the revenue cycle landscape. Here's what billing teams need to know.
Impact on Revenue Cycle Operations
The implications vary by organization size and current technology stack, but common impacts include:
- Workflow changes: New processes and documentation requirements
- System updates: Technology infrastructure modifications needed
- Staff training: Team members must learn new procedures
- Compliance timelines: Immediate or near-term implementation deadlines
What RCM Leaders Should Do Now
- Assess impact — Review how this affects your organization
- Update workflows — Modify processes to comply with new requirements
- Train staff — Ensure team knows new procedures
- Monitor compliance — Track adherence to avoid denials
🗺️ Confused About Network Routing?
PayorMap shows you exactly which umbrella network is repricing your dental claims—and where your carve-out opportunities are. No guessing, no spreadsheets.
Source: Dental Economics