tracelogoRB Reference Guide for CIGNA Medicare Advantage 

 

This contract is for CIGNA's Medicare Advantage Plan (sometimes called "Part C" or "MA Plan").

 

MA Plans are offered by private companies, (such as CIGNA,  BCBSNC, United Healthcare, etc.) that have been approved by Medicare.  

 

Individuals that join a Medicare Advantage Plan still have Medicare but coverage is from the Medicare Advantage Plan and not Original Medicare

 

The CIGNA Medicare Advantage Plan covers those same chiropractic services covered by original Medicare.

 

This Quick Reference Guide provides information specific to the CIGNA Medicare Advantage Plan concerning claims, members, and policies.

 

Effective 01.01.20 no CIGNA MA Plan requires either PCP referral OR preauthorization. 

 

General Information

 

Eligibility/Benefits

 

Claims Submission

 

Claims Inquiries

 

Provider Relations

 



General Information

 

Please do not send claims directly to CIGNA Medicare Advantage.  All CIGNA Medicare Advantage claims must be sent to HNS.

 

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. You are under contract as a participating CIGNA Medicare Advantage provider through HNS and our instructions for filing claims supersede information given to you by CIGNA Medicare Advantage Representatives!

 

If you have any questions about CIGNA Medicare Advantage, please contact your HNS Service Representative at (877) 426-2411 before calling CIGNA Medicare Advantage.

 

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Eligibility/Benefits

 

Be sure to ALWAYS verify eligibility for each CIGNA Medicare Advantage member! 

 

Verify member eligibility using one of the following options:

 

Online through https://HealthSpring.hsconnectonline.com/HSConnect.

 

Interactive Voice Response (IVR) System at 1-800-230-6138.  The IVR System is available 24 hours a day, 7 days a week.

 

Please remember to ask for specific information on chiropractic benefits for each member. CLICK HERE to see a sample Verification of Eligibility/Benefit Form.  

 

To verify eligibility and benefits - Refer to the telephone number on the member's identification card   

  

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Claims Submission

 

All CIGNA Medicare Advantage claims must be submitted to HNS. All primary claims must be submitted electronically to HNS.

 

CLICK HERE for information on filing corrected claims.

 

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 Medicare Advantage claims to adjudicate quickly and accurately, please note the following information regarding claims submission specific to CIGNA Medicare Advantage is in addition to the HNS instructions under Filing Claims to HNS.

 

    • HealthSpring must be in box 11c.
    • Even when filing the claim electronically, the claim must be identified as a HealthSpring claim in the address section at the top of the CMS 1500 claim form (HNS/HealthSpring is an acceptable format) using the example below:

 

Example:    HNS/HealthSpring
                    PO Box 2368
                    Cornelius, NC 28031 

 

 

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Claims Inquiries

 

For tracing outstanding claims (after 60 days from your billing date), please email your HNS Service Rep and include the patient name, date of birth, member ID number and the dates of services in question. We will gladly trace the claim for you and will respond back to you within three business days.

 

Resubmit lost/missing claims through HNS.

 

Refer to your HNS/CIGNA Medicare Advantage fee schedule to confirm allowable amounts if prior authorization was obtained before rendering services.

 

 

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Provider Relations 

 

Questions relating to your participation in CIGNA Medicare Advantage should be directed to your HNS Service Representative at (877) 426-2411.

 

 

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