 cigna HEALTHCARE quick reference guide for chiropractic
The CIGNA HealthCare Quick Reference Guide provides information specific to CIGNA HealthCare concerning CIGNA HealthCare
members, CIGNA HealthCare claims, and CIGNA HealthCare policies. The information in this section is in addition to the HNS/Payor Policies, HNS Documentation and HNS Billing Guidelines.
NOTE: CIGNA HealthCare Corporate Medical Policy for Chiropractic takes precedence over any information you receive from CIGNA telephone representatives for CIGNA members. Please contact your HNS Provider Rep to determine if a particular service is consistent with CIGNA Corporate Medical Policy.
CLICK HERE for the CIGNA HealthCare Corporate Medical Policy for Chiropractic
If you have any questions about any CIGNA related topic, please contact your HNS Provider Rep at
(877) 426-2411.
The CIGNA HealthCare Quick Reference Guide contains the following information specific to CIGNA HealthCare and provides you with helpful information regarding your CIGNA HealthCare patients.
General Information
Eligibility/Benefits
Referral System
CIGNA ID Cards
Claims Submission
Claims Inquiries
Provider Relations
General Information
Important Note.
CIGNA CARE PLAN
Because chiropractic is not currently one of the specialties included in the "CIGNA CARE NETWORK", HNS providers are not 'in-network' for the CIGNA CARE PLAN.
PLEASE REMEMBER: Do not send claims directly to CIGNA HealthCare! Please ignore the claims billing address on the member ID card or any address given to you on the telephone when verifying eligibility and benefits. If you inadvertently send your CIGNA claims directly to CIGNA rather than to HNS, your claims will be processed at 'out-of-network' benefits, so please remember to send all CIGNA claims to HNS.
Our instructions for filing claims supersede information given to you by CIGNA HealthCare Representatives.
CIGNA HealthCare will not reimburse you for any services other than those listed on the new CIGNA fee schedule. Services other than those listed on the fee schedule will be denied by CIGNA HealthCare. To be sure that you are familiar with the CPT codes listed on this new CIGNA fee schedule, please print a copy and keep it in a convenient location for quick reference. All HNS fee schedules are located on the secure portion of the HNS website: www.HealthNetworkSolutions.net.
With only a few exceptions, all claims for COVERED SERVICES provided to a beneficiary of a HNS contracted payor MUST be submitted to HNS.
If you have any questions about a CIGNA HealthCare claim, please contact your HNS Provider Rep at (877) 426-2411 before calling CIGNA HealthCare.
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CIGNA HealthCare will only reimburse you for services listed on the new CIGNA fee schedule. Services other than those listed on the fee schedule will be denied by CIGNA HealthCare. Please remember to ask for specific information on chiropractic benefits for each member. CLICK HERE to see a sample Verification of Benefits Form.
- See the member ID card for the correct number to call to verify eligibility and benefits. (Chiropractic benefits vary by plan and most plans have benefit and/or visit limitations.)
- For CIGNA HealthCare members, you may also call (800) 88-CIGNA.
SPECIAL NOTE: When asked for your Federal Tax ID number (EIN), you must give the HNS Federal Tax ID (56-1971088). CIGNA has all HNS participating providers listed under the HNS Federal Tax ID number.
- CIGNA HealthCare also leases their provider network to Third Party Administrators. For CIGNA TPAs, please refer to the back of the member's ID card for telephone numbers or you may use the phone numbers listed below:
Boiler Makers |
866-342-6555 |
MVP |
888-687-6277 |
| MVP Kodak |
800-999-3920 |
MVP Preferred Care |
888-851-8030 |
Health Partners |
800-444-4558 |
APWU |
800-222-2798 |
SAMBA |
800-638-6589 |
NALC |
888-636-6252 |
Starbridge Select |
800-308-5948 |
Aftra |
800-562-4690 |
FDA (JCP) |
866-337-8417 |
American Maritime Officers |
800-348-6515 |
Plumbers & Pipefiitters |
888-741-2673 |
Seafarers Health & Benefit Plan |
800-252-4674
|
Sheet Metal Workers |
615-859-0131 |
Tufts Health Plan |
888-884-2404 |
- You may also verify eligibility and benefits on the CIGNA for HealthCare Professionals web site, www.cignaforhcp.com. If you do not already have a username and password, please contact your HNS Provider Rep and we will gladly assist you.
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Referral System
- Generally speaking, most products are a direct access plan and referrals from a PCP or prior authorization is normally not necessary. There may be a few self-funded plans that have special rules and may require a referral or prior authorization so ALWAYS ask when verifying benefits.
- When it is necessary to refer to another healthcare provider, referrals within the network are required unless there are no participating CIGNA providers in the area where the patient is being referred.
- ALL Orthotics must be referred to Linkia, please CLICK HERE for instructions on how to refer a patient to Linkia.
- ALL DME purchases must be referred to CareCentrix, please
CLICK HERE for instructions.
cigna ID cards
Claims for ALL CIGNA plans must be filed to HNS through HNSConnect with the exception of the CIGNA Indemnity plan and some of the Third Party Administrators. For CIGNA claims filed through HNS, please note the following:
- If the patient needs pre-certification, the pre-certification requirement is shown on the back of the ID card as either "Inpatient Admission" or "Inpatient Admission and Outpatient Procedures." For chiropractic, if it states "Inpatient Admission and Outpatient Procedures," please make sure when verifying eligibility and benefits that chiropractic does not need pre-certification on ANY services to be rendered on the patient.
- The "Away from Home" logo indicates member has access to the CIGNA national network.
- ID cards with the CIGNA Care Network logo indicate the member liability varies based on the provider's CIGNA Care Network designation.
CLICK HERE to view the various CIGNA member ID cards that are filed to HNS.
If you are uncertain about where to file the claim, please use your HNS Fax Inquiry Form and fax a clear, legible copy of the member ID card to HNS and we will respond back to you with an answer within 24 hours.
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Claims Submission
All claims for CIGNA HealthCare plans must be submitted to HNS through the HNSConnect system. Exceptions include secondary claims, corrected claims, claims with attachments, and some of the Third Party Administration claims. Some CIGNA Third Party Administrator claims come to HNS electronically, and some must be mailed to us on paper CMS 1500 claim forms. Please see below to identify which CIGNA TPA claims are submitted to HNS by mail (on CMS 1500 claim forms).
CLICK HERE for information on filing secondary claims.
CLICK HERE for information on filing corrected claims.
Please remember that all primary claims must be filed to HNS within 10 days from the date of service.
Effective August 1, 2011 CIGNA HealthCare's timely filing policy is:
NC CIGNA HealthCare Timely Filing Policy is 180 days
SC CIGNA HealthCare Timely Filing Policy is 90 days
Please ignore any instructions regarding where to submit claims by payor phone representatives! HNS instructions regarding where to submit claims supersede all other instructions given by payor representatives when verifying eligibility and benefits.
In order for CIGNA HealthCare claims to adjudicate quickly and accurately, please note the following information regarding claims submission specific to CIGNA HealthCare in addition to the HNS Billing Guidelines.
- Group or Policy number must be in box 11 (often called "Account #" on CIGNA ID card).
- Claims must be identified in box 11c as "CIGNA"
- Box 17, referring provider, must be left blank on all CIGNA HealthCare claims.
- All CIGNA Third Party Administrator (TPA) claims must be submitted electronically through HNSConnect unless noted below:.
The following CIGNA TPA claims must be submitted to HNS on CMS 1500 claim forms and mailed to the HNS address.
MVP
MVP Kodak
MVP Preferred Care
Health Partners
Starbridge Select (CIGNA network will be listed on the ID card)
FDA (JCP)
Sheet Metal Workers
Tufts Health Plan
- When filing the claim electronically, the claim must be identified as a CIGNA claim in the address section at the top of the CMS 1500 claim form (HNS/CIGNA is an acceptable format) using the example address below:
EXAMPLE: HNS/CIGNA
PO Box 2368
Cornelius, NC 28031
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Claims Inquiries
- You may now check the status of your claims using the CIGNA for HealthCare Professionals web site, www.cignaforhcp.com. If you do not have access to the CIGNA web site, please CLICK HERE for instructions.
- For tracing outstanding claims (after 60 days from your billing date), complete the HNS Fax Inquiry Form and fax to HNS. Please include the patient name, date of birth, member ID number, and each date of service you would like traced. We will gladly trace the claim for you and will respond back to you within 3 business days.
- Resubmit lost/missing claims through HNS.
- Contact your HNS Provider Rep if you have any questions relating to the adjudication of your CIGNA claims.
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Provider Relations
Questions relating to your participation in these CIGNA products should be directed to your HNS Provider Rep at (877) 426-2411.
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