wlink.graphnet.com Open in urlscan Pro
192.206.112.170  Public Scan

Form analysis
0 forms found in the DOM

Text Content

DIGITAL SOLUTIONS UPDATE



Improving eligibility verification for patients with third-party administrator
plans

Beginning October 31, 2023, when you verify eligibility for patients with a
third-party administrator (TPA) plan, the electronic data interchange (EDI) 271
transaction will indicate whether they are covered or not covered using
information from Cigna Healthcare, as well as the TPA. It will also provide the
TPA name and telephone number to confirm further eligibility or benefit
information.

What this means for you
This enhancement will provide more clarity in the coding used by clearinghouses
and electronic medical records vendors to electronically confirm eligibility for
your patients and provide information on the entity to contact for benefit
details. You may still need to call the TPA for further information.

What are TPA plans?
Employer groups who require a high level of customization and flexibility may
choose to have TPAs administer their benefit plans. Cigna Payer Solutions has
relationships with select TPAs to help meet the needs of employer groups by
providing a wide range of complementary product solutions, including access to
our medical network of providers.

How do I determine if my patient has a TPA plan?
You have two options to determine if your patient has a TPA plan: View their ID
card or log in to the Cigna for Health Care Professionals website
(CignaforHCP.com) to review their coverage details.

Patients with a TPA plan will have “Shared Administration” (or the letter “S”)
at the bottom right of their TPA ID card (see the sample below). This designates
that Cigna Healthcare shares the administration of the plan with a TPA. The ID
card also includes the TPA phone number to call for eligibility and benefits
information (see the sample below).


   
See above for "Shared Administration" identifier.        See above for
eligibility/verification phone number. 


Thank you for the care you provide to our customers.

Provider Digital Solutions & Engagement Cigna Healthcare









All Cigna Healthcare products and services are provided exclusively by or
through operating subsidiaries of The Cigna Group, including Cigna Health and
Life Insurance Company (CHLIC), Connecticut General Life Insurance Company,
Evernorth Behavioral Health, Inc., Evernorth Care Solutions, Inc., Express
Scripts, Inc., or their affiliates.

PCOMM-2023-1682© 2023 Cigna. Some content provided under license.