Provider Customer Service: 1 (800) 230-6138, Provider Website: MedicareProviders.Cigna.com, Provider Manual: 2022 Provider Manual [PDF], ID Card Examples: 2022 Provider Manual [PDF] > Customer Identification Cards, Provider Portal: HSConnectOnline.comHelp Desk: 1 (866) 952-7596Email: HSConnectHelp@HSConnectOnline.com, ICD-10 Coding & Documentation/360 Comprehensive Assessment:Provider Education and Assessment Tools, Quest Diagnostic LaboratoriesCall: 1 (866) 697-8378. open positions so continue your job search at Cigna.com/careers, Clinical Information to Establish Medical Necessity, Peripheral Nerve Disorders Imaging Guidelines, Peripheral Vascular Disease Imaging Guidelines, Pediatric Musculoskeletal Imaging Guidelines, Pediatric Peripheral Nerve Disorders Imaging Guidelines, Pediatric Peripheral Vascular Disease Imaging Guidelines, Radiation Oncology Clinical Appeal Documentation Requirements, Bone Metastases - Xofigo Physician Worksheet, Central Nervous System Lymphoma Physician Worksheet, Central Nervous System Neoplasm Physician Worksheet, Extracranial Oligometastases Physician Worksheet, Gastric Stomach Cancer Physician Worksheet, Liver Cancer, Selective Internal Radiation Therapy Physician Worksheet, Non Cancerous Radiation Therapy Physician Worksheet, Non-Hodgkins Lymphoma Physician Worksheet, Non-Small Cell Lung Cancer CDS Online Document, Other Metastases (Non-Bone/Brain) Physician Worksheet, Lung Cancer, Small Cell Physician Worksheet, Prophylactic Cranial Irradiation (PCI) Radiation Therapy Physician Worksheet, Ureter/Urethral Cancer Physician Worksheet, Site of Care: Outpatient Hospital for Select Musculoskeletal Procedures, Interventional Pain Management Quick Reference Guide Guideline, Joint Surgery Quick Reference Guide Guideline, Preface to Comprehensive Musculoskeletal Management Guidelines, Epidural Adhesiolysis (CMM-207) Guideline, Epidural Adhesiolysis (CMM-207) Guideline - Effective 05/31/2023, Epidural Steroid Injections (CMM-200) Guideline, Epidural Steroid Injections (CMM-200) Guideline - Effective 05/31/2023, Facet Joint Injections / Medial Branch Blocks (CMM-201) Guideline, Facet Joint Injections / Medial Branch Blocks (CMM-201) Guideline - Effective 05/31/2023, Hip Replacement/Arthroplasty (CMM-313) Guideline - Effective 05/31/2023, Hip Replacement/Arthroplasty (CMM-313) Guideline, Hip Surgery Arthroscopic and Open Procedures (CMM-314) Guideline, Hip Surgery Arthroscopic and Open Procedures (CMM-314) Guideline - Effective 05/31/2023, Implantable Intrathecal Drug Delivery System (CMM-210) Guideline, Implantable Intrathecal Drug Delivery System (CMM-210) Guideline - Effective 05/31/2023, Knee Replacement Arthroplasty (CMM-311) Guideline - Effective 05/31/2023, Knee Replacement Arthroplasty (CMM-311) Guideline, Knee Surgery: Arthroscopic and Open Procedures (CMM-312) Guideline - Effective 05/31/2023, Knee Surgery: Arthroscopic and Open Procedures (CMM-312) Guideline, Prolotherapy (CMM-204) Guideline - Effective 05/31/2023, Radiofrequency Joint Ablations/Denervations (CMM-208) Guideline - Effective 05/31/2023, Radiofrequency Joint Ablations/Denervations (CMM-208) Guideline, Regional Sympathetic Blocks (CMM-209) Guideline, Regional Sympathetic Blocks (CMM-209) Guideline - Effective 05/31/2023, Sacroiliac Joint Procedures (CMM-203) Guideline, Sacroiliac Joint Procedures (CMM-203) Guideline - Effective 05/31/2023, Shoulder Surgery (CMM 315) Arthroscopic and Open Procedures Guideline - Effective 05/31/2023, Shoulder Surgery (CMM 315) Arthroscopic and Open Procedures Guideline, Shoulder Arthroplasty/ Arthrodesis (CMM-318) Guideline - Effective 05/31/2023, Shoulder Arthroplasty/ Arthrodesis (CMM-318) Guideline, Spinal Cord and Dorsal Root Ganglion Stimulation (CMM-211) Guideline - Effective 05/31/2023, Spinal Cord and Dorsal Root Ganglion Stimulation (CMM-211) Guideline, Gastrointestinal Endoscopic Procedure Esophagogastroduodenoscopy (EGD), Gastrointestinal Endoscopic Procedure Esophagogastroduodenoscopy (EGD) - Effective 06/15/2023, Gastrointestinal Endoscopic Procedure Capsule Endoscopy, Gastrointestinal Endoscopic Procedure Capsule Endoscopy - Effective 06/15/2023, Error eviCore has a national network of providers who offer these services. Facilities considered for the Cigna LifeSOURCE Transplant N etwork must be a Cigna-participating provider and maintain hospital accreditation (e.g., Joint Commission of Hospital endstream endobj startxref For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. The website includes several educational materials: frequently asked questions documents, quick reference guides, provider training presentations, DME and O&P precertification form, and lists of Healthcare Common Procedure Coding System codes that require precertification through Cigna. <> stream Good health and a good doctor/patient relationship begins with understanding your patients' cultural, ethnic, racial and linguistic needs. %%EOF Cigna Medicare Advantage Plans . %%EOF 128 0 obj <>stream Alere Home Monitoring, Inc. dba Acelis Connected Health Services: Hearing aids, replacement hearing aid batteries for non-rechargeable hearing aids, charging stations for rechargeable hearing aids, supplies, and personal sound amplification products, Fetal monitoring services, including use of electronic devices to check a babys heartbeat before and during childbirth, electronic fetal monitoring, fetal stress tests, and baby heartbeat monitors. Details. 58 0 obj <> endobj Claims questions: 1 (800) 230-6138 | Appeals questions: 1 (800) 511-6943 | Fax: 1 (800) 931-0149Electronic claims may be submitted through: Paper Claims: Cigna Medicare Advantage, PO Box 981706, El Paso, TX 79998Appeals: Cigna Medicare Advantage Appeals, PO Box 188081, Chattanooga, TN 37422Reconsideration Requests: Cigna Medicare Advantage Reconsiderations, PO Box 20002 Nashville, TN 37202, Mail: Cigna Medicare AdvantageAttn: Special Investigations UnitPO Box 20002, Nashville, TN 37202, Email: SpecialInvestigations@Cigna.comAttn: Cigna Medicare Operations. Durable medical equipment (including orthotics and prosthetics), home health, and home infusion As of February 1, 2021, eviCore healthcare (eviCore) manages home health care, durable medical equipment (DME), and home infusion therapy for Cigna commercial customers. General Information: Provider Customer Service: 1 (800) 230-6138 Provider Website: MedicareProviders.Cigna.com Provider Manual: 2022 Provider Manual [PDF] ID Card Examples: 2022 Provider Manual [PDF] > Customer Identification Cards Provider Portal: HSConnectOnline.com Help Desk: 1 (866) 952-7596 Email: HSConnectHelp@HSConnectOnline.com ICD-10 Coding & Documentation/ To know the process of editing PDF document or application across the online platform, you need to follow these . On January 1, 2023, eviCore began managing the provider network for orthotics and prosthetics (O&P) services for Cigna commercial customers. There are some exceptions to these deadlines. 5281 0 obj <>stream Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. Cigna may not control the content or links of non-Cigna websites. Your secure provider portal for working with Cigna The information, tools, and resources you need to support the day-to-day needs of your office are all on the Cigna for Health Care Providers' website, CignaforHCP.com : Check patient eligibility and benefits Check claims, payments, and fee schedules Update your Cigna provider directory information If you're unable to file a claim right away, please make sure the claim is submitted accordingly. Reproduction or retransmission of the materials, in whole or in part, in any manner, without the prior written consent of the copyright holder, is a violation of copyright law. CocoDoc has made it easier for people to Modify their important documents by online browser. For prior authorizations, access our interactive Prior Authorization Requirements (a searchable reference guide updated quarterly) at MedicareProviders.Cigna.com > Forms and Practice Support > Prior Authorization Requirements. Browse Medical Resources Medical Reference Guides Here you'll find reference guides to help make it easier for health care professionals to do business with Cigna. Watch this presentation to learn more about cultural competence and the important role you play as a provider. endobj As of February 1, 2021, eviCore healthcare (eviCore) manages home health care, durable medical equipment (DME), and home infusion therapy for Cigna commercial customers. Medicare patients' claims must be filed no later than the end of the calendar year following the year in which the services were provided. 75 0 obj <>/Filter/FlateDecode/ID[<6199C9EC628D61409439B9F09F0CF70A>]/Index[58 71]/Info 57 0 R/Length 86/Prev 105393/Root 59 0 R/Size 129/Type/XRef/W[1 2 1]>>stream This is useful for forms that you want to view and/or print. If you have any questions or would like more information about participating in a Cigna health care network, please contact us. All material on this website is, unless otherwise stated, the property of eviCore healthcare. Clinicians are expected to use independent medical judgment which takes into account the clinical circumstances to make individual management decisions. Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (LINA) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (NYLGICNY) (New York, NY), formerly known as Cigna Life Insurance Company of New York. a listing of the legal entities <> If a claim was timely filed originally, but Cigna requested additional information. that insure or administer group HMO, dental HMO, and other products or services in your state). From professional newsletters to wellness programs to Cigna medical plans and more, this is the medical health care professional's source for information. Silver&Fit is a registered trademark of ASH and used with permission herein. Report Fraud & Abuse | 1 0 obj This web site uses files in Adobe Acrobat Portable Document Format (PDF). The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna. %PDF-1.6 % 3 0 obj reCAPTCHA is not valid; Please try again! All insurance policies and group benefit plans contain exclusions and limitations. Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (LINA) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (NYLGICNY) (New York, NY), formerly known as Cigna Life Insurance Company of New York. See the criteria (PDF) Office manual for health care professionals hbbd``b` SK(La "$[" rD @Ua$"C 6#I#s Z guidelines at-a-glance flyer or visit our updated provider COVID-19 web page at CignaforHCP.com. Clinical decisions, including treatment decisions, are the responsibility of the individual and his/her provider. eviCore's clinical guidelines are evidence-based and apply to the following categories of service for individuals with Cigna-administered plans: The terms of an individual's particular coverage plan document [Group Service Agreement (GSA), Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD), or similar plan document] may differ significantly from the standard coverage plans upon which these guidelines are based. Cigna does not control the linked sites' content or links. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. vaccine, please review our . that insure or administer group HMO, dental HMO, and other products or services in your state). Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. For provider resources or customer service: Provider Resources www.eviCore.com/Resources/Healthplan/Cigna-Medicare, Clinical Guidelines: www.eviCore/com/Provider/Clinical-Guidelines, Web Portal Support:Email: PortalSupport@eviCore.comCall: 1 (800) 646-0418 (option 2), Non-Precertification Inquiries:ClientServices@eviCore.comCall: 1 (800) 575-4517 (option 3), Clinical Support/Program Inquiries:Email: ClientServices@eviCore.comCall: 1 (888) 693-3211Fax: 1 (888) 693-3210, Medical Oncology:Call: 1 (866) 668-9250Fax: 1 (800) 540-2406, Radiation Therapy:Call: 1 (866) 686-4452Fax: 1 (866) 699-8128, Provider Resources:Call: 1 (888) 693-3297Fax: 1 (888) 693-3210Send clinical questions/case examples to eviCores client and provider service team, Clinical Support/Program Inquiries:Email: ClientServices@eviCore.comCall: 1 (800) 298-4806PAC Fax: 1 (800) 575-4429HHC Fax: 1 (855) 826-3724, Call: 1 (866) 686-4452Fax: 1 (866) 663-7740. Selecting these links will take you away from CignaforHCP.com. 3277 0 obj <>stream After one year and prior to four years from the date of determination, "good cause" is required for Medicare to reopen the claim. Read our quick-reference guide (PDF) Network participation criteria We have a set of criteria for participation in our provider network. To search the Prior Authorization guide for a code, enter Ctrl+F > the 5-digit code. We'll discuss the salient differences between them to make selection easier - and more accurate - for you: Provider networks Unlike in an HMO plan where you must visit your PCP and maintain one all year-long, you don't have to do that. For information on Oscars policies and procedures, For the A to Z on Oscar's clinical criteria, For current state-specific reimbursement policies, For general Quality information and improvement guides. 3250 0 obj <> endobj Thank you for using eviCores website today! These include: If you are not currently registered for the Cigna for Health Care Providers website, go to CignaforHCP.com and click on the Login/Register link. Find PA forms at MedicareProviders.Cigna.com > Forms and Practice Support > Prior Authorization Requirements. To submit a Prior Authorization request:Visit the Provider Portal at HSConnectOnline.com. Details, Applicable law requires a longer filing period, Provider agreement specifically allows for additional time, In Coordination of Benefits situations, timely filing is determined from the processing date indicated on the primary carrier's explanation of benefits (EOB) or explanation of payment (EOP). Copyright 2022 eviCore healthcare. eviCore has a national network of providers who offer these services. As a valued user of our website, wed appreciate your feedback to help us improve your website experience. Please click here to register for an account. %PDF-1.5 % Helping you keep up with research, trends, and policy changes that impact your practice. As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, of authorization request(s). All Rights Reserved. Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see @ >9{$I@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@`t3186?;>YY_H@kukU%dL@3!7aPf47J@&2@#j8H8N YBiYB`h2052b4e"F GfCIUKF3L[e%,d Y gY")% y\ UP2 M|1B~