Nebraska Department of Insurance
THE NEBRASKA HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE (NICA) PROGRAM
MARCH 2001 NICA NEWS
GOLD RECORDS
Record 3/01 (B. Stiles): Client received a call from a Home Health agency requesting assistance in getting records corrected so they could receive payment for one month's oxygen supplied to the client. Client had been covered under her husband's group health plan with Medicare as the secondary payer. He retired and her Medicare Supplement plan became effective on September 1 and Medicare became primary. The September bill for the oxygen was the one in question with Medicare saying that the group plan was the primary payer. The NICA Volunteer contacted the CIGNA office in Tennessee and explained the insurance changes. CIGNA said the records would be corrected and payment made accordingly.CIGNA is the regional Medicare Carrier for claims for durable medical equipment and supplies. Their address and phone number: CIGNA Medicare, DMERC Region D, PO Box 690, Nashville, TN 37202, 1-800-899-7095.
Record 4/010 (J. Catlin): NICA Volunteer looked through a stack of bills. The supplement was not paying because the beneficiary had not canceled with her former HMO in Tulsa, Oklahoma before receiving treatment in Holdrege, NE. NICA Volunteer appealed with the HMO.
If a beneficiary wants to disenroll from their HMO because they are unhappy or dissatisfied with services, or for any other reason, they must submit a written request to disenroll. The HMO should help complete any necessary paperwork and process written requests for disenrollment in a timely manner.