CCN OAP front cover - CHG Healthcare Services

Introduction
5
TRANSITIONAL CARE
There may be instances in which your primary physician becomes unaffiliated
with the CIGNA HealthCare network of participating providers. In such cases,
you will be notified and provided assistance in selecting a new primary
physician.
However, in special circumstances, you may be able to continue seeing your
doctor, even though he or she is no longer affiliated with CIGNA HealthCare.
If you have a special circumstance for which you have been receiving care,
such as a life-threatening illness or degenerative or disabling disease or
condition, you may be eligible to receive “transitional care” from that nonparticipating
provider for up to 90 days. You may also be eligible to receive
transitional care if you are in your second trimester of pregnancy.
In this case, transitional care may continue through your delivery and postpartum
care. Such transitional care must be approved in advance by CIGNA
HealthCare, and your doctor must agree to accept our reimbursement rate and
to abide by CIGNA HealthCare policies and procedures and quality assurance
requirements. There may be additional circumstances where continued care by
a provider no longer participating in the CIGNA HealthCare network will not
be available, such as when the provider loses his/her license to practice or
retires.
If you are a new member who has a special circumstance for which you have
been receiving care, such as a life-threatening illness or degenerative or
disabling disease or condition, you may be eligible to receive “continuity of
care” from that non-participating provider for up to 60 days. You may also be
eligible to receive continuity care if you are in your second trimester of
pregnancy. In this case, continuity of care may continue through your delivery
and post-partum care. Such continuity of care must be approved in advance by
CIGNA HealthCare, and your doctor must agree to accept our reimbursement
rate and to abide by CIGNA HealthCare policies and procedures and quality
assurance requirements. There may be additional circumstances where
continued care by a provider no longer participating in the CIGNA HealthCare
network will not be available, such as when the provider loses his/her license
to practice or retires.