Natera and Synergen are sending emails and text messages to patients with UHC and Cigna insurance plans because they require patient signatures in order to submit a second level appeal on emerging products (Signatera and Prospera).
This will expand to other payors in the weeks to come.
These cases will be flagged in AMD with a memo that says: “2nd level appeal. Agent use 2nd Level Appeal Script”.
Patients may mention they have received an email with a subject line that says “UHC or Cigna Designated Authorization Form”, or “Member Authorization”.
Also, the subject line on that email may say “Help Natera Help You”, “Help Natera Save you Money” or “Natera Needs Your Help to Help You”
All Panamericom agents need to warm transfer the call to UHC level 2 and provide the following script:
“Let me connect you with our Appeals Team who can better assist you. Can you also write down their phone number in case you need to call them back? Would you like their email address too? If all agents are busy, you will have the option to leave a voicemail. Please hold the line while I transfer you”
- Email: [email protected]
- Phone: 650-489-9050
- Monday to Friday 8:00 am to 4:00 pm CST
If agent is available then introduce yourself and the patient’s information:
“Hi, this is xxxx from Billing. I have xxx on the line and she/he is calling about a UHC/Cigna second level appeal. Her case number is xxxx, and she has been HIPAA verified.”
CHAT SCRIPT
“A member of our Member Appeals team can you assist you, please email them at [email protected] to discuss your case. You can also call them at 650-489-9050, if you prefer.”
It will take 24 hours for the Appeals Team to call back or return an email.
If the patient does not want to be contacted anymore, please say: “I can remove you from the email list, and you will continue to be billed. Please reply STOP to the text message to be removed” and escalate the request by sending a “Do Not Contact” ticket in Syncro CRM to take appropriate actions.
If the patient wants to pay, they can do so with the Appeals Team.
Last update by: Claudia F (August 20, 2024)