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PPO Negotiation Solutions

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GEHA Patients are in for Changes Starting January 2025

December 13, 2024

As of January 1, 2025, GEHA and Cigna will no longer allow the communication of Cigna’s fee schedules. This change could significantly impact how you serve your GEHA patients, especially if you’re not part of other lease agreements that facilitate communication with GEHA plans.

Why Does This Matter?

If your practice relies on Cigna’s fee schedule for GEHA patients, this shift could disrupt claims processing and reimbursement workflows. It’s crucial to address this change proactively to maintain seamless support for your GEHA patients.

Fortunately, alternative lease communication options exist to help your practice adapt and continue serving these patients without interruption.

Lease Communication Options

Here are the main options for lease communication with GEHA:

  • GEHA (Direct) – Available only in certain states.
  • Connection
  • Careington

However, it’s essential to understand the specifics of how these networks communicate with GEHA plans. This is particularly true for federal plans, as not all lease agreements cover every plan type. Evaluating these options thoroughly will help you make informed decisions for your practice.

What You Need to Do

  1. Evaluate Your Patient Base:
    Determine how many GEHA patients your practice serves and which plans they’re enrolled in. This understanding will clarify how these changes might affect your operations.
  2. Research Network Options:
    When exploring new lease communications, assess how each network communicates with GEHA and other insurance plans. Focus on plan compatibility to ensure your patients’ coverage needs are met.
  3. Request Payor Lists:
    Contact each network to obtain payor lists and detailed information about supported plans. This step is vital to ensuring you choose the right communication agreement for your practice.

Don’t Leave Your Patients—or Your Practice—at Risk!

These upcoming changes underscore the importance of staying informed and making proactive adjustments to your practice’s lease agreements. Waiting too long could jeopardize patient care and your revenue stream.

Get Expert Support with PPO Negotiation Solutions

Navigating these changes doesn’t have to be overwhelming. PPO Negotiation Solutions offers expert guidance tailored to your unique needs. We’ll help you:

  • Understand the complexities of network communication options.
  • Evaluate lease communication options.
  • Ensure your practice remains compliant and profitable.

Contact PPO Negotiation Solutions today for a personalized consultation and take the first step in preparing your practice for the changes ahead. With our help, you can ensure your patients continue receiving the high-quality care they deserve while protecting your practice’s bottom line.

Stay Ahead of the Changes—Act Now!

Filed Under: Dental Revenues Tagged With: GEHA and Cigna

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PPO Negotiations, LLC
8183 Rhode Dr
Shelby Township, MI 48317
Mon – Thu: 7:30 am – 5:00 pm
Fri: 7:30 am – 4:00 pm

Local: 586.803.7501
Toll Free: 888.421.1808
Fax: 586.803.7506
Email: info@spsolutionteam.com

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