Cigna

This information (other than the National Health Insurer Report card results) has been provided to the AMA by Cigna.

Cigna home page

Health Care Professionals home page

Contracted Fee Schedule
Registration required

Payment rules
Please note the following clarifications to Cigna's payment policies:

• Co-surgeon policy: Co-surgery is based on the medical necessity for multiple surgeries to be conducted at the same time rather than a defined list of CPT codes that are allowed.
• Payment based on the relationship of procedure code to diagnosis code: Individual Coverage Positions include the relationship of procedure code to diagnosis code.

Please note that Cigna does not list the following information online:

• Definition of global surgery periods
• Patient's assignment of benefits to a non-participating physician

Payer-Specific Claim Edits
Registration required

Medical policies

Clinical reimbursement policies and payment policies
To access these policies, visit www.cignaforhcp.com, then select "Resources".

Clinical health and wellness information
To access this information, visit www.cignaforhcp.com, then select "Resources", then "Medical Resources".

Precertification List

Multiple Surgery Guidelines  

Multiple Procedure Reduction Logic

Cigna Cost of Care Estimator - Registration required
This online tool helps practices create an estimate of the patient's payment responsibility. To access this tool, visit www.cignaforhcp.com, then select "Estimate Patient Liability".

Appeals
Policies and procedures

Electronic health care transactions:

• Claims submission
• Claims status
• Eligibility
• Prior Authorization (registration required)

Referral requests:

• Electronic remittance advice
  Cigna does not require enrollment to exchange claims submission, claims status, eligibility and referral requests through a clearinghouse or vendor. Physician practices can work directly with their vendor to start sending those transactions with nothing additional needed by Cigna.
  
  Physician practices can also register to perform claim status, eligibility or referral requests at www.cignaforhcp.com

• Electronic Fund Transfer Information

Educational materials on using features of Cigna For Health Care Professional website and exchanging EDI transactions with Cigna can be found on the secure Cigna for Health Care Professionals website www.cignaforhcp.com under "Education and Help".

National Health Insurer Report Card
Review the NHIRC for this year and past years to see how Cigna stacks up on a variety of critical metrics.

Health Insurer Financial Information:

Health insurer financials
The AMA has compiled a resource that highlights health insurer SEC filing data since 2006. This resource provides information based on company filings for the seven largest national publicly traded health insurers: Aetna, Cigna, Coventry, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem.

Health insurer state fines
The AMA has compiled a resource that lists the fines health insurers have incurred in each state and the reasons for the fines. This resource underscores the importance of reporting unfair payer practices.

Health insurer CEO compensation
The AMA has compiled a resource that highlights health insurer SEC filing data, including CEO compensation since 2006. This resource provides information based on company filings for the seven largest national publicly traded health insurers: Aetna, Cigna, Coventry, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem.