Cigna offers best in-class clinical resources at global and local levels, allowing for the effective adjudication of medical necessity, orthodoxy and appropriately-priced treatment. Cigna's dedicated local team of medical professionals provide clinical programmes across all dimensions of health thus enabling the patient's access to the most appropriate treatment in the most appropriate location and setting.
Our clinical case management consists of finding the right balance between maintaining the patient's comfort & well-being, respecting treatment protocols and cutting down on the cost of the plan.
Cigna Clinical has a referral trigger list in place which includes complex medical diagnosis & financial threshold values, the point of identification of cases is at the pre-authorization point. Case management includes but is not limited to visits to meet the member at the point of service; regular case discussion with the treating doctors and nursing staff; medical necessity review of the management of the case per Cigna & internationally recognized clinical guidelines; utilization reviews; file audits; closure of final hospital bills; follow up post discharge, chronic case management & decision support.