1. LAKELAND CARE PAYER CONFERENCE OCTOBER 19, 2016

2. Verifying Eligibility
You can change the date to view eligibility & benefits for up to 2 years in the past, or up to 30 days in the future.
cignaforhcp.com
Multi-Payer Websites such as NaviNet
Customer Service: Cigna ( )
Verify eligibility:
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3. Verifying Eligibility & benefits
Scroll to view benefits by medical category
Obtain patient eligibility
Estimate costs
View benefits by medical category
View claims
cignaforhcp.com
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

4. Precertification
Cigna’s outpatient precertification list is available to download at cignaforhcp.com > Resources > Clinical Reimbursement & Payment Policies > Precertification
If you are logged into cignaforhcp.com, you will be prompted to accept NaviNet’s privacy policies and a new window will appear so you can begin precertification.
Lead in Message:
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

5. HIGH TECH RADIOLOGY & musculoskeletal PRECERTIFICATION
Cigna works with eviCore healthcare (formerly Med Solutions) to administer a precertification program for the following high tech radiology and musculoskeletel services.
Precertification is required through eviCore healthcare for the following services:
CT/CTA Nuclear cardiology imaging
MRI/MRA Stress echocardiogram
PET Diagnostic left and right heart catheterization
Interventional Pain Management Major joint surgery (hip, knee, shoulder)
Precertification can be requested
in one of three ways:
Online: myportal.medsolutions.com
Phone: (888) (8:00 am – 9:00 pm EST)
Fax: (888)
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6. CLAIM SUBMISSION
Cigna encourages electronic claim submission using Cigna Payer ID 62308
COB claims: Submit primary and secondary (COB) claims electronically using loops 2320 and You don’t have to submit Medicare Part A and Part B coordination of benefits agreement (COBA) claims to us. The Medicare EOB or ERA will show that those claims have been forwarded to us as the secondary payer.
Corrected claims: Use the Claim Frequency Type Code in loop 2300, segment CLM05, to specify the frequency of the claim (this is the third position of the UB04 bill type)
Use one of the following codes to indicate the claim type:
1 – Original (admit through discharge claim)
7 – Replacement (of a prior claim), include Payer Claim Control # in segment REF*F8
9 – Void (or cancellation of prior claim), include Payer Claim Control # in segment REF*F8
When a corrected claim is submitted, you will receive a “duplicate to claim already in process” denial message and the corrections will be applied to the original claim.
Claim Mailing Address: PO Box , Chattanooga, TN
Cigna primary claims must be submitted within 180 days of the date of service. Secondary claims must be submitted within 180 days of the receipt of the primary payers EOB.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

7. Appeal SUBMISSION Appeals:
Cigna offers a single-level appeal process. Appeals must be initiated within 180 calendar days of the date of the initial payment or denial decision.
Decisions are made and communicated within 60 days of receipt of the appeal.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

8. ExAMPLE ID CARD
Cigna ID cards list the plan type and any copay on the right-hand side. The back of the card contains contact information, claim submission guidelines and precertification requirements.
Please use cignaforhcp.com for deductible and coinsurance insurance.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

9. Cost of Care Estimator:
Provides an itemized estimate for specific services.
Shows the patient’s out of pocket expenses based on their plan.
Helps facilitate financial discussions between you and your patients.
Cost of Care Estimator:
Select PRINT PATIENT ESTIMATE to print a copy for the patient.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

10. Coach by Cigna
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

11. QUESTIONS Thank you, Lauren Koons (860) 787-6847