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Payor Relations

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Payor Relations works to support the Managed Care Department and UTMB by acting as a liaison between the hospital system and the insurance company (Payor/Payer). This small team handles several key responsibilities to ensure proper communication and escalation of issues between both parties.

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Payor News

Health Care Services Corporation acquisition of Cigna Healthcare Medicare business complete

On March 19, 2025, The Cigna Group completed the sale of its Medicare and CareAllies businesses to Health Care Service Corporation (HCSC). This divestment streamlines Cigna’s portfolio and focuses its efforts on innovation. The transaction does not affect Cigna’s commercial business or existing contracts. For 2025, processes and coverage for Medicare and CareAllies customers remain unchanged with no disruption. Providers can refer to HCSC contacts for patients under HCSC-managed plans. Both Cigna and HCSC are committed to a smooth transition and value ongoing partnerships.

Superior Healthplan News: Transition of Utilization Review from TurningPoint to Evolent Effective for Cardiology Procedures beginning July 1, 2025

Effective 7/1/25, Evolent Specialty Services, Inc., will now manage the Utilization Review of cardiology services and procedures, taking the place of TurningPoint Healthcare Solutions, LLC. After 7/1/25, prior authorizations for applicable non-emergent, cardiology services must now be requested through Evolent. This change applies to Superior HealthPlan Medicaid (STAR, STAR Health, STAR+PLUS), STAR+PLUS Medicare-Medicaid Plan (MMP) and Wellcare By Allwell Medicare members aged 21 and older, and Ambetter from Superior HealthPlan members aged 18 and older.

Meet the Team