When Cigna Healthcare's R49 policy made headlines in October 2025, many assumed it was an isolated case. Cigna Healthcare then paused the policy due to regulatory pressure. The relief was short-lived. The trend didn't stop; it had already spread to nearly every major insurer in the country.
This article examines how Cigna Healthcare’s R49 policy and NBC News' recent investigation reveal a growing challenge for healthcare providers and how our Downcoding Defense Tools help practices stay compliant and protect their revenue.
Aetna’s CCRP quietly began downcoding high-level E/M claims in March 2025, joining Cigna’s R49 policy effective Oct 1. Providers face hidden revenue loss, delayed payments, and rising admin burden. Learn how Downcoding Defense™ tools protect your practice.
Sep 296 min read
In fact, one healthcare provider we worked with achieved 132% of monthly collection goals.
