QUICK GUIDE TO CIGNA ID CARDS 2014-2015

Page created by Leon Ferguson
 
CONTINUE READING
QUICK GUIDE TO CIGNA ID CARDS 2014-2015
2014-2015

                              QUICK GUIDE TO
                              CIGNA ID CARDS

591795 r 06/14 THN-2014-256
QUICK GUIDE TO CIGNA ID CARDS 2014-2015
WE PACK A LOT OF
IMPORTANT INFORMATION
ON OUR ID CARDS.
This brochure can help define and clarify information
that appears on Cigna’s most common customer ID
cards. It can also help you understand the requirements
associated with our various plans, allowing you to
quickly and efficiently serve your patients.
We may occasionally update this brochure during the
year. Download the most current version at Cigna.com >
Health Care Professionals > Resources > Doing Business
with Cigna.

PLEASE NOTE:
There are various standard Cigna ID cards shown in this
brochure that are subject to regulatory oversight. As a
result, the actual ID card content may vary in order to
conform to legislative and regulatory requirements.
The ID cards shown are samples and may vary from the
actual cards.
QUICK GUIDE TO CIGNA ID CARDS 2014-2015
KEY
Refer to this key for explanations of the information
found on the sample Cigna ID cards featured in
this brochure.

1 Use this ID number for all claims and inquiries.

2 Indicates a seamless network where a patient can
  receive in-network care on a regional or statewide basis.

3 For patients with coinsurance, submit claims to Cigna
  or its designee, and receive an Explanation of Payment
  (EOP), which will show any remaining amount due
  from patient.

4 Collect any copayment at the time of service.

5 May read as “Connecticut General Life Insurance Co.,”
  “Cigna Health and Life Insurance Company” or  “Cigna
  HealthCare of XXXX, Inc.”

6 ID cards with the Cigna Care Network® logo indicate
  the patient’s liability varies based on the health care
  professional’s Cigna Care designation status. Refer
  to the online health care professional directory to
  determine a physician’s Cigna Care designation status.

7 Effective date of coverage.

8 Name of patient‘s primary care physician (PCP).

9 Network Savings Program (NSP) logo indicates
  that out-of-network discounts may be available to
  the customer.

10 Client name.

11 If a third party administers services in conjunction with
   Cigna, the ID card may include multiple logos and may
   show a different claim address or telephone number on
   the back of the card.

12 Precertification requirements may be shown as either
   “Inpatient Admission” or  “Inpatient Admission and
   Outpatient Procedures.’’

13 Submit claims to the claim submission address shown
   on the card.

14 Call the Customer Service number(s) indicated on
   the card. Some plans have dedicated numbers for
   accessing information – be sure to check the card for
   the correct number.

15 “Away From Home Care” indicates the patient has
   access to the Cigna national network.

16 Indicates Shared Administration.

17 Union identifier.

18 Client-specific network (CSN) logo.
QUICK GUIDE TO CIGNA ID CARDS 2014-2015
THE MYCIGNA MOBILE APP:
     APP-SOLUTELY CONVENIENT
     The myCigna Mobile App gives customers a simple way to personalize, organize and
     access their important health and benefits information – on the go. Cigna customers
     may present their ID card information, claims information and coverage eligibility to
     you via the app with their cell phone or tablet.

     FEATURES:
     ID cards
     •    Quickly view ID card information (front and back) for the entire family
     •    Easily print, email or scan right from smartphone Health care professional directory
     •    Locate doctors and health care facilities
     •    Access maps for instant driving directions
     Health wallet
     •    Store and organize all contact info for doctors, hospitals and pharmacies
     •    Add health care professionals to contact list right from a claim or directory search
     Claims
     •     View and search recent and past claims
     •    Bookmark and organize claims for easy reference
     Trackers
     •    View in-network and out-of-network medical and dental year-to-date deductibles,
          as well as out-of-pocket and annual maximums
     Coverage
     •    See plan coverage and benefit information for medical, dental, pharmacy
     •    Access and view health fund balances
     •    Review plan deductibles and coinsurance
     Drug search
     •    Compare prescription drug costs at more than 60,000 pharmacies nationwide
     •    Find closest pharmacy location using GPS

                       Customers can get the free myCigna Mobile App
                       from the App StoreSMor Google Play
                       iOS Apple version 5.1 or higher
                       Android OS version 2.3 or higher

    The Apple logo is a trademark of Apple Inc., registered in the U.S. and other countries. App Store is a service
    mark of Apple Inc. | Android and Google Play are trademarks of Google Inc.
    *The myCigna Mobile App is only available to Cigna health plan customers. Actual features may vary depending
    on your plan. The downloading and use of the App is subject to the terms and conditions of the App and the
    online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply.
1
QUICK GUIDE TO CIGNA ID CARDS 2014-2015
Primary Care $30       Specialist $40
                                                                                                                                                                    Urgent Care $65        Preventive Care $20           Members and Providers Call
                                                                                                                                                                    PCP: None Selected                                   1-866-494-2111
                                                                                                                                                                    No Referral Required
                                RUN_DATE
                                DATA_SEQ_NO
                                CLIENT_NUMBER
                                UHG_TYPE
                                DOC_ID
                                DOC_SEQ_ID
                                NAME
                                MAILSET_NUMBER
                                CUST_KEY1
                                CUST_KEY2
                                CUST_KEY3
                                CUST_KEY4
                                CUST_KEY6
                                CUST_KEY5
                                       Doe
                                         9116687/000001-00
                                         9116687/000001-01
                                         9116687/000001-02
                                             20130314
                                             DIG1CARD
                                              00699998
                                              100000008
                                              00
                                              John
                                              Doe
                                               0000001
                                                 0000001
                                                    003040
                                                      0000001
                                                        05:58:28
                                                            ,John For plan & benefit details, please visit myCIGNAforhealth.com
                           CUST_KEY5
                           RUN_DATE
                           DATA_SEQ_NO
                           CLIENT_NUMBER
                           UHG_TYPE
                           DOC_ID
                           DOC_SEQ_ID
                           NAME
                           MAILSET_NUMBER
                           CUST_KEY1
                           CUST_KEY2
                           CUST_KEY3
                           CUST_KEY4
                           CUST_KEY6
                                Doe
                                  9116687/000001-00
                                  9116687/000001-01
                                  9116687/000001-02
                                     20130314
                                     DIG1CARD
                                      00699998
                                      100000008
                                      00
                                      John
                                      Doe
                                       0000001
                                          0000001
                                            003040
                                              0000001
                                                05:58:28
                                                    ,John         Plan Contractor: Connecticut General Life Insurance Company

                                                                                                                                                        11                                                               Members: Carry this card at all times. Pretreatment authorization must be obtained for hospital

                                                                                                                                                                                                                                                                                                                                                                                     *117**117*
                                                                                                                                                                               GWH-Cigna
                                                                                                                                                                                  Plan Type                              admissions, outpatient surgeries performed outside a physician’s office and for the other services
                                                                                                                                                                              GWH-CIGNA
                                                                                                                                                                                PlanAccess
                                                                                                                                                                              Open   Type                                specified in the benefit plan. Member is responsible for obtaining authorization for non-network
                                                                                                                                                                                 Plus                                    services. Failure to follow pretreatment authorization procedures may result in a reduction of
                                                                                                                                                                                                                         benefits. In an emergency, seek care immediately, then call your primary care doctor as soon as

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Health Management, Inc. and Cigna Dental Health, Inc. The Cigna Dental
                                                                                                   XYZ Company                                                                                                           possible for further assistance. We encourage you to use a primary care physician as a valuable

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    management services provided by Cigna Dental Health, Inc., and certain
                                                                                                                                                                                                                                                                                                                                                                                                     its operating subsidiaries. All products and services are
                                                                                                                        10

                                                                                                                                                                                                                                                                                                                                                                                                                                             Inc. The Cigna Dental

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Life Insurance Company, Cigna Health and Life Insurance Company, Cigna
                                                                                                                                         >000001

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    PPO is underwritten or administered by Connecticut General LIfe Insurance
                                                                                                   RXBIN 600428                                                                                                          resource and personal health advocate.

                                                                                                                                                                                                                                                                                                                                                                                                                                                               certain
                                                                                                                                                                                                                                                                                                                                                                                 Corporation and its operating subsidiaries. All products and services are

                                                                                                                                                                                                                                                                                                                                                                                 Life Insurance Company, Cigna Health and Life Insurance Company, Cigna
                                                                                                                      >000001

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Corporation. Such operating subsidiaries include Connecticut General
                                                                                                                                                                                                                                                                                                                                                                                 PPO is underwritten or administered by Connecticut General LIfe Insurance

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Company or Cigna Health and Life Insurance Company with network
                                                                                                                                                                                                                                                                                                                                                                                                                                                          a service
                                                                                                   RXPCN 05180000

                                                                                                                                                                                                                                                                                                                                                                                                                                                                    provided by or through such operating subsidiaries and not by Cigna
                                                                                                                                                                                                                                                                                                                                                                                 Corporation. Such operating subsidiaries include Connecticut General

                                                                                                                                                                                                                                                                                                                                                                                                                                                      is network
                                                                                                                                                                                                                                                                                                                                                                                 upon our agreement with your provider. Your provider may bill you
                                                                                                                                                                                                                         CIGNA has multiple networks. Your plan is paired with the GWH-CIGNA network. To find a

                                                                                                                                                                                                                                                                                                                                                                                                                                                           Cigna
                                                                                                                                                                                                                                                                                                                                                                                 'Cigna' is a registered service mark, and the 'Tree of Life' is a service

                                                                                                                                                                                                                                                                                                                                                                                 provided by or through such operating subsidiaries and not by Cigna
                                                                                                   Issuer 80840

                                                                                                                                                                                                                                                                                                                                                                                 Your share of the payment for health care services may be based
                                                                                                                                                                                                                                                                                                            upon our agreement with your provider. Your provider may bill you

                                                                                                                                                                                                                                                                                                                                                                                 mark, of Cigna Intellectual Property, Inc., licensed for use by Cigna
                                                                                                                                                                                                                         GWH-CIGNA provider, please visit your member website at myCIGNAforhealth.com.

                                                                                                                                                                                                                                                                                                                                                                                                                                                   Inc.,byand
                                                                                                                                                                                                                                                                                                            Your share of the payment for health care services may be based
                                                                                                   Group Plan 123456789                                                                                                  Providers: Pretreatment authorization must be received for all services listed above and as
                                                                                                   John Public
                                                                                                                                                                                           13                    12

                                                                                                                                                                                                                                                                                                                                                                                                                                                   with
                                                                                                                                                                   Submit All Claims To                                  specified in the member’s benefit plan by calling the number on the front of this card or online

                                                                                                                                                                                                                                                                                                                                                                                                                                             for use
                                                                                                                                                                                                                                                                                                                                                                                 Company or Cigna Health and Life Insurance CompanyLife'
                                                                                                                                                                   PO Box 188061                                         at CignaforHCP.com. Emergency hospital admissions must be reported within 48 hours.
                                                                                                   ID 123456789 01        1

                                                                                                                                                                                                                                                                                                                                                                                                                                           Health,
                                                                                                                                         9116687

                                                                                                                                                                                                                                                                                                                                                                                                                                         charges.
                                                                                                                      9116687                                      Chattanooga, TN 37422 - 8061

                                                                                                                                                                                                                                                                                                            for amounts up to the provider's regular billed charges.

                                                                                                                                                                                                                                                                                                                                                                                                                                             of
                                                                                                   COPAY:                                                                                                                Notice: Possession of this card does not guarantee coverage or payment for the service or
                                                                                                                                                                   Payer ID #62308
                                                                                                   Primary Care $30       4         Specialist $40                                                                       procedure reviewed. Please call the Member and Providers number on the front of this card for

                                                                                                                                                                                                                                                                                                                                                                                                                                     Health,

                                                                                                                                                                                                                                                                                                                                                                                                                                   licensed
                                                                                                                                                                                                                                                                                                                                                                                                                                       'Tree
                                                                                                   Urgent Care $65                  ER $200                                                       14                     eligibility information.

                                                                                                                                                                                                                                                                                                                                                                                                                            Inc., Dental
                                                                                                                                                                   Members and Providers Call

                                                                                                                                                                                                                                                                                                                                                                                                                                billed
                                                                                                   PCP: None Selected
                                                                                                                                8

                                                                                                                                                                                                                                                                                                                                                                                                                                  the
                                                                                                                                                                   1-866-494-2111
                                                                                                                                                                                                                  9                                                     For providers not in your primary

                                                                                                                                                                                                                                                                                                                                                                                                                           Dental
                                                                                                   No Referral Required                                                                                                                                                 network, visit multiplan.com

                                                                                                                                                                                                                                                   What does it mean?

                                                                                                                                                                                                                                                                                                                                                                                                                           and
                                                                                                                                                                                                                                                                                                                                                                                                                      by Cigna
                                                                                                                                                                                                                       What does it mean?

                                                                                                                                                                                                                                                                                                                                                                                                                       regular
                                                                                                   For plan & benefit details, please visit myCIGNAforhealth.com                                                             For Pharmacists Only 1-800-XXX-XXXX
                                                                                                                                         001
                                                                                                                      001

                                                                                                                                                                                                                                                                                                                                                                                                                 Property,
                                                                                                                                                                                                                                                                                                                                                                                                                    mark,
                                                                                                                                                                                                                             R318 (5/10)                                           Mask 401                                                                                                           Issue Date: 01/01/12

                                                                                                                                                                                                                                                                                                                                                                                                                and Cigna
                                                                                                                                                                                                                                                                                                                                                                                                           provider's

                                                                                                                                                                                                                                                                                                                                                                                                           provided
                                                                                                                                                                                                                                                                                                                                                                                                           service
                                                                                                                                         003040

                                                                                                  • PCP selection encouraged
                                                                                                                      003040

                                                                                                                                                                                                                                                                                                                                                                                                   Intellectual
                                                                                                                                                                                                                                                                                                                                                                                                  subsidiaries.
                                                                                                                                                                                                                                                                                                                                                                                                up to theInc.
                                                                                                  • No referrals required

                                                                                                                                                                                                                                                                                                                                                                                               registered
                                                                                                                                                                                                                                                                                                                                                                                 mark, of Cignaservices
                                                                                                                                                                                                                                                                                                                                                                                          Management,
GWH-Cigna Plans

                                                                                                  • GWH-Cigna ID cards represent all products

                                                                                                                                                                                                                                                                                                                                                                                                and
                                                                                                                                                                                                                                                                                                                                                                                    its operating
                                                                                                                                                                                                                                                                                                                                                                                 management
                                                                                                                                                                                                                                                                                                                                                                                 for amounts

                                                                                                                                                                                                                                                                                                                                                                                 Corporation
                                                                                                                                                                                                                                                                                                                                                                                 'Cigna'  is a
                                                                                                                                                                                                                                                                                                                                                                                 Health

                                                                                                                                                                                                                                                                                                                                                                                 of
                                                                                                                                                                   11
    03040 9116687 0000 0000001 0000001 072 7 117

                                                   03040 9116687 0000 0000001 0000001 072 7 117

                                                                       Cigna Health and Health
                                                                                Cigna   Life Insurance
                                                                                                and LifeCompany
                                                                                                         Insurance Company
                                                                                                                                                                                                                 12
                                                                                                                                                                        5
                                                                       Group 00699998
                                                                                Group 00699998
                                                                       Issuer (80840)
                                                                                 Issuer (80840)
                                                                       ID 100000008
                                                                                 ID 100000008                    Copays        Copays 41
                                                                       Name JohnName
                                                                                   Doe John Doe                  Primary Care Primary
                                                                                                                               $25      Care $25
                                                                       PCP NonePCP Selected
                                                                                        None Selected 8          Specialist $25Specialist $25
                                                                       No ReferralNo
                                                                                   Required
                                                                                      Referral Required          Urgent Care  $100
                                                                                                                               Urgent Care $100
                                                                                                                 ER $200       ER $200
                                                                       XYZ SampleXYZ CompanyHoldings   Co.
                                                                                        Sample CompanyHoldings Co. 10                                                                                                                   PO All
                                                                                                                                                                                                                 13 Send All Claims ToSend BoxClaims
                                                                                                                                                                                                                                                188061To
                                                                                                                                                                                                                                                       Chattanooga, TN 37422Drive
                                                                                                                                                                                                                                                                             - 8061  Payer ID #62308
                                                                                                                                                                                                                                                           1000 Great-West         Kennett, MO  63857-3749 Payer ID #62308
                                                                                                                                                                                                                       Customers & Customers
                                                                                                                                                                                                                                         Health    Care Professionals      call  1-866-494-2111
                                                                       RxBIN 600428   RxPCN 05180000                                                                                                             14 Rx Claims: Pharmacy    Service Center,&PO
                                                                                                                                                                                                                                                            Health    Care
                                                                                                                                                                                                                                                              Box 3598,      Professionals
                                                                                                                                                                                                                                                                        Scranton  PA 18505-0598call 1-866-494-2111
                                                                               RxBIN 600428
                                                                       RxGrp 00688888         RxPCN 05180000                                                                                                                         Rx Claims:ForPharmacy    Service
                                                                                                                                                                                                                                                    Pharmacists  OnlyCenter, PO Box 3598, Scranton PA 18505-0598
                                                                                                                                                                                                                                                                       800-351-9170
                                                                               RxGrp 00688888                                                                                                                                                                      For Pharmacists Only 800-351-9170
                                                                       RxID 100000008 00
                                                                               RxID 100000008 00                                                                                                                  9
                                                                                                                                                                                                                                                                              Mask 601                                                                                                    Issue Date: 03/14/13
                                                                                                                                                                                                                                                                                                            Mask 601                                                                                         Issue Date: 03/14/13

                                                                                                  • PCP selection encouraged
                                                                                                  • No referrals required
                                                                                                  • GWH-Cigna
                                                                                                          00000000ID cards represent all products
                                                                                                                              00000000
                                                                                                                            DIRECT
                                                                                                           USPS                     DIRECT
                                                                                                                            USPS
                                                             John Doe
                                                                      John
                                                             888 N Main  St Doe
                                                             Olympia, 888
                                                                       WA N98502
                                                                             Main St
                                                                      Olympia, WA 98502
                                                                                                                                                                                                                                             20130313
                                                                                                                                                                                                                                                          20130313
                                                                                                                                                                                                                                            Thu Mar 14, 2013 @ 05:58:28
                                                                                                                                                                                                                                             N           Thu Mar 14, 2013 @ 05:58:28
                                                                                                                                                                                                                  12                                                        N
Global Health Benefits

                                                                                                                                                    1                                                                      601
                                                                                                                                                                                                                                                        601

                                                                                                                                                   10

                                                                                                                                                                                                                  14
                                                                                                                                                                                                                  13
                                                                                                                                                                                                                                  9                                                                                                                                             15

                                                                                                  • PCP selection encouraged
                                                                                                  • Patients in these Cigna-administered plans use Cigna PPO or Cigna OAP networks in the U.S., as indicated on the back of the card
                                                                                                  • Network Savings Program logo on back of card indicates out-of-network discounts may apply

                                                                                                                                                                                                                                                                                                                                                                                                                                                         2
QUICK GUIDE TO CIGNA ID CARDS 2014-2015
Cigna Choice Fund Open Access Plus                                                                                                                                                                        WWW.CIGNA.COM
                                                                               TPV logo
                                                                                                          CSN logo       18
                                                                                              11                                              Client            You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                                                             Cigna
                                                                                                          Care Network    6                    logo             You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.

                                                                            Legal entity name 5
                                                                                                                                                             12 INPATIENT ADMISSION:
                                                                                                                                                                Your provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents for your
                                                                            Coverage effective date: MM/DD/CCYY 7            Choice Fund OA Plus                pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
                                                                            Group: 1234567                                      No referral required            care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                                                                                                                PCP Visit     15%/20%
                                                                                                                                Specialist 3 15%/20%
                                                                            Issuer (80840)                                                                      Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
                                                                            ID: U23456789 01 1                                  Hospital ER        20%          For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                            Name: John Public                                   Vision               Yes        For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                                                                                Rx       30%/40%/50%
                                                                            PCP: John Smith
                                                                                 PCP Name Ln2    8                              Network   Coinsurance:       13 Send claims to:
                                                                                                                                In            90%/10%           CAD Name, PO Box XXXX, Anytown, USA 12345-6789
®

                                                                            PCP Phone: XXX.XXX.XXXX                             Out           70%/30%           TPV Name, PO Box XXXX, Anytown, USA 12345-6789
                                                                            ID card acct name 10                                Med/Rx deductible applies       All Others: PO Box XXXX, Anytown, USA 12345-6789
                                                                            RxBIN XXXXXX RxPCN XXXXXXXX logo 9
                                                                                                                 NSP
                                                                                                                                                                Customer Service: 1.800.XXX.XXXX 14 MH/SA: 1.800.XXX.XXXX
                                                                                                                                                                                                                                                                                             16
                                                                            DOI                         Network Savings Program                       Cat#      We encourage you to use a PCP as a valuable resource and personal health advocate.                  AWAY FROM HOME CARE

                                                                   •   PCP selection encouraged                                                                 • Coinsurance/deductible should not be collected at the time of service unless
                                                                   •   Cigna Choice Fund® and medical plan type indicated                                         you have accessed the Cigna Cost of Care Estimator®on the Cigna for Heath Care
                                                                   •   Most coinsurance information shown                                                         Professionals website (CignaforHCP.com) to obtain an estimate of the patient’s
                                                                   •   Coinsurance/deductible is paid directly to the doctor/facility by Cigna using              costs, and provide a copy of the estimate to the patient
                                                                       patient’s available health funds. Explanation of Payment (EOP) will show any             • Collecting at the time of service without accessing the Cigna Cost of Care Estimator
                                                                       remaining amount due from patient                                                          may result in overpayment and require a refund to the patient

                                                                                                                                                                You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                                TPV logo       11                                              Client           You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
                                                                                                                                                logo         12 INPATIENT ADMISSION:
                                                                                                                                                                Your provider must call the toll-free number listed below to pre-certify your medical services or benefits may be affected. Refer to your
                                                                            Legal entity name 5
                                      Shared Administration PPO

                                                                                                                                                                plan documents for your plan’s precertification requirements. In an emergency, seek care immediately, then notify Cigna within 48 hours.
                                                                            Coverage effective date: MM/DD/CCYY     7    Provider network:                      Mail all non-medical claims and correspondence to: ID card name back
                                                                            Group: 1234567                               Cigna HealthCare PPO                   SAR fund name
                                                                            Issuer (80840)                                 Doctor visit $10 4                13 Submit/mail claims to: Cigna Payor 62308, PO Box 188004, Chattanooga, TN 37422-8004
                                                                                                                                                                All other:
                                                                            ID: U23456789 01 1                             Specialist   $20
                                                                                                                           Coinsurance 3                        TPV N&A print line
                                                                            Name: John Public
                                                                                                                           In-network      90% / 10%            Pre-certification: Member Srvc Nu                  Pharmacy Questions: 1.800.244.6224
                                                                            S 16
                                                                            This plan is self-funded by:
                                                                                                                           Out-of-network 70% / 30%             Eligibility, Benefit and Claim questions please call: SAR TPA phone            14
                                                                                                                           Rx         30% / 40% / 50%
                                                                            ID card account name                                                                To access the online provider directory go to www.CignaSharedAdministration.com
                                                                            Fund #: SAR F                                                                       To access member pharmacy tools go to www.myCigna.com
                                                                            RxBIN Rx Bin RxPCN XXXXXXXX                       Deductible applies
                                                                            DOI
                                                                                                                                                   Cat#
                                                                                                                                                             15         AWAY FROM HOME CARE                      Benefits are not insured by Cigna HealthCare        17
Shared Administration (SAR)

                                                                  • Cigna Care Network is available

                                                                                                                                                                You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                               TPV logo     11                                                Client            You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
                                                                                                                                               logo          12 INPATIENT ADMISSION:
                                                                           Legal entity name 5                                                                  Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
                                                                           Coverage effective date: MM/DD/CCYY      7
                                      Shared Administration OAP

                                                                                                                                                                for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
                                                                           Group: 1234567                                  Open Access Plus                     primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                                                           Issuer (80840)                                   No referral required                Mail all non-medical claims and correspondence to:
                                                                           ID: U23456789 01 1                               PCP visit $15 4                     Fund name
                                                                           Name: John Public                                Specialist $20                      Fund address
                                                                           S 16                                             Rx 30% / 40% / 50%                  Send claims to: Claims address 13
                                                                           PCP: James Smith                                 Network coinsurance:                All others: PO Box XXXX, Anytown, USA 12345-6789
                                                                                PCP name Ln2                                In 90% / 10% 3                      Pre-certification: Member Srvc Nu                  Pharmacy Questions: Pharm Num
                                                                           PCP phone: 860-555-1212                          Out 70% / 30%                       Eligibility, Benefit and Claim Questions: Please call Payor Num          14
                                                                           Fund Name                                        Deductible applies                  To access the online provider directory go to www.cignasharedadministration.com
                                                                           Fund #: Fund number                                                                  To access member pharmacy tools go to www.mycigna.com
                                                                           RxBIN XXXXXX RxPCN XXXXXXXX                                                          We encourage you to use a PCP as a valuable resource and personal health advocate.
                                                                           DOI                                                                     Cat#                 AWAY FROM HOME CARE               15                                                      17

                                                                   • PCP selection encouraged
                                                                   • No referrals required
                                                                   • Cigna Care Network is available

                           3
CSN logo        18                                                                                          WWW.CIGNA.COM
                                                                      TPV logo       11                                               Client
                                                                                                                                       logo            You may be asked to present this card when you receive care. The card does not guarantee coverage. You must comply with all
                                                                                               Cigna
                                                                                            Care Network        6                                      terms and conditions of the plan. Willful misuse of this card is considered fraud.

                                                                   Legal entity name                        5       5                               12 INPATIENT ADMISSION:
                                                                                                                                                       Your provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents for your
                                                                   Coverage effective date: MM/DD/CCYY                Network Open Access
                                                                   Group: 1234567
                                                                                                            7         No referral required
                                                                                                                                                       pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
                                   Network Open Access

                                                                                                                                                       care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                                                   Issuer (80840)                                      PCP Visit        $10/$25
                                                                                                                                                          For information about mental health services and coverage, call MHSA Stmt Tel
                                                                   ID: U23456789 01 1
                                                                                                                       Specialist       $10/$25
                                                                   Name: John Public                                   Hospital ER 4        $50           Med Group: Sunset Med Group
                                                                   PCP: James Smith 8
                                                                                                                       Urgent   Care        $25           Send claims to: 123 Main Street, Suite 999, Anytown, USA 12345-6789 13
                                                                                                                       Vision               Yes           For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                        PCP Name Ln2
                                                                                                                       Rx $10/20%/40%/100%                For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                   PCP Phone: XXX.XXX.XXXX                             Rx Indiv Deduct      $50           Cigna Claims: PO Box XXXX, Anytown, USA 12345-6789
                                                                   ID card acct name 10
                                                                                                        NSP                                  3            TPV Name, PO Box XXXX, Anytown, USA 12345-6789
                                                                   RxBIN XXXXXX RxPCN XXXXXXXX logo 9 Coinsurance applies                                 CSN Name, PO Box XXXX, Anytown, USA 12345-6789
                                                                   DOI                         Network Savings Program                        SAR         Customer Service: 1.800.XXX.XXXX 14        MH/SA: 1.800.XXX.XXXX

                                                           • PCP selection encouraged
                                                           • No referrals required
                                                           • In-network coverage only, except emergency care

                                                                                                                                                                                                  WWW.CIGNA.COM
Managed Care Plans: Open Access

                                                                                         CSN logo       18
                                                                    TPV logo       11                                                  Client          You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                                            Cigna
                                                                                                            6                           logo           You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
                                                                                         Care Network

                                                                   Legal entity name 5
                                                                                                                                                    12 INPATIENT ADMISSION AND OUTPATIENT PROCEDURES:
                                                                                                                                                       Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
                                                                   Coverage effective date: MM/DD/CCYY 7              Open Access Plus                 for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
                                                                   Group: 1234567                                      No referral required            primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                                                   Issuer (80840)                                      PCP visit       $10/$25
                                   Open Access Plus

                                                                                                                       Specialist      $10/$25         For pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                   ID: U23456789 01 1                                  Hospital ER          $50 4      For vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                   Name: John Public                                   Urgent  care         $25
                                                                   PCP: James Smith 8                                  Vision               Yes           Send claims to:
                                                                        PCP Name Ln2                                   Rx            $10/20/30            CAD name, PO Box XXXX, Anytown, USA 12345-6789
                                                                                                                       Network Coinsurance:               TPV name, PO Box XXXX, Anytown, USA 12345-6789
                                                                                                                                                                                                              13
                                                                   PCP phone: XXX.XXX.XXXX                             In             90%/10%
                                                                   ID card acct name 10                                Out 3          70%/30%             All others: PO Box XXXX, Anytown, USA 12345-6789
                                                                                                       NSP
                                                                   RxBIN XXXXXX RxPCN XXXXXXXX logo 9                  Med/Rx deductible applies          Customer service: 1.800.XXX.XXXX 14      MH/SA: 1.800.XXX.XXXX
                                                                   DOI                        Network Savings Program                       Cat#          We encourage you to use a PCP as a valuable resource and personal health advocate. 15        AWAY FROM HOME CARE

                                                           •   PCP selection encouraged
                                                           •   No referrals required
                                                           •   Open Access Plus: In-network and out-of-network coverage
                                                           •   Open Access Plus In-network: In-network coverage only, except emergency care

                                                                                        CSN logo
                                                                                                                                                                                                       WWW.CIGNA.COM
                                                                   TPV logo                                                          Client
                                                                                                                                                       You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                                           Cigna                            2         logo             You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
                                                                                        Care Network

                                                                  Legal entity name
                                                                                                        5                                           12 INPATIENT ADMISSION:
                                  HMO or POS Open Access

                                                                                                                                                       Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
                                                                  Coverage effective date: MM/DD/CCYY 7              POS (or HMO) Open Access
                                                                                                                                                       for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
                                                                  Group: 1234567                                      No referral required
                                                                                                                                                       primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                                                  Issuer (80840)                                      PCP Visit       $15/$25
                                                                                                                      Specialist 4 $15/$25                For information about mental health services and coverage, call MHSA Stmt Tel
                                                                  ID: U23456789 01 1
                                                                  Name: John Public                                   Hospital ER          $50            Med Group: Sunset Med Group 13
                                                                                                                      Urgent Care          $25            Send claims to:
                                                                  PCP: James Smith 8                                  Vision               Yes
                                                                       PCP Name Ln2                                                                       For pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                                                                      Rx $10/20%/40%/100%                 For vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                  PCP Phone: XXX.XXX.XXXX                             Rx Indiv Deduct      $50            Cigna claims: PO Box XXXX, Anytown, USA 12345-6789
                                                                  ID card acct name 10                                                                    TPV name, PO Box XXXX, Anytown, USA 12345-6789
                                                                  RxBIN XXXXXX RxPCN XXXXXXXX logo    NSP 9           Coinsurance applies 3               CSN name, PO Box XXXX, Anytown, USA 12345-6789
                                                                  DOI                        Network Savings Program                         SAR          Customer service: 1.800.XXX.XXXX 14      MH/SA: 1.800.XXX.XXXX

                                                           •   PCP selection encouraged
                                                           •   No referrals required
                                                           •   HMO Open Access: In-network coverage only, except emergency care
                                                           •   POS Open Access: Offered as an HMO or Network plan; in-network and out-of-network coverage

                                                                                                                                                                                                                                                                                         4
CSN logo                                                                                            WWW.CIGNA.COM
                                                                              TPV logo         11                            18                      Client
Managed Care Plans: LocalPlus®
                                                                                                                                                                       You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                                                                                                      logo             You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
                                                                                                                                                                       INPATIENT ADMISSION AND OUTPATIENT PRECEDURES: 12
                                                                          Legal entity name
                                                                                                                                                                       Your provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents for your
                                                                          Coverage effective date: MM/DD/CCYY
                                                                                                                           LocalPlus                                   pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
                                                                          Group: 1234567                                     No referral required                      care doctor as soon as possible for further assistance and directions on follow-up care within EF hours.
                                                                          Issuer (80840)                                     PCP Visit           $10                   Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
                                                                          ID: U23456789 01 1                                 Specialist          $15 4
                                                                                                                                                                       Carve out 1 Prt Line
                                                                                                                                                                       Carve out 2 Prt Line 13
                                                                          Name: John Public                                  Hospital ER         $50
                                                                                                                             Urgent Care         $25
                                                                          PCP: James Smith                                   Vision               Yes                  Send claims to:
                                                                               Jane Smith                                    Rx            $10/20/30                   CAD Name, PO Box XXXX, Anytown, USA 12345-6789
                                                                          PCP Phone: 860.123.4567                            Network coinsurance:                      TPV Name, PO Box XXXX, Anytown, USA 12345-6789
                                                                          ABC12 & Sons Company                               In            90%/10%
                                                                                                                             Out           70%/30%                     All Other: PO Box XXXX, Anytown, USA 12345-6789
                                                                                                              NSP
                                                                          RxBIN XXXXXX RxPCN XXXXXXXX logo 9 Med/Rx deductible applies                                 Customer Service: 1.800.XXX.XXXX 14          MH/SA: 1.800.XXX.XXXX                             Open Access Plus         15
                                                                          DOI                        Network Savings Program                        Cat #              We encourage you to use a PCP as a valuable resource and personal health advocate.                  AWAY FROM HOME CARE

                                                                ••   PCP
                                                                       PCPselection
                                                                            selectionencouraged
                                                                                       encouraged                                                                   • Coinsurance/deductible should not be collected at the time of service unless
                                                                ••   Cigna  Choice  Fund® and medical plan type indicated
                                                                       No referral required                                                                           you have accessed the Cigna Cost of Care Estimator®on the Cigna for Heath Care
                                                                ••   Most  coinsurance
                                                                       LocalPlus:        information
                                                                                  In-network          shown
                                                                                               and out-of-network     coverage                                        Professionals website (CignaforHCP.com) to obtain an estimate of the patient’s
                                                                ••   Coinsurance/deductible    is paid directly to except
                                                                                                                   the doctor/facility                                costs, and provide a copy of the estimate to the patient
                                                                       LocalPlus IN: In-network   coverage  only,         emergencyby  careCigna using
                                                                     patient’s available health funds. Explanation of Payment (EOP) will show any                   • Collecting at the time of service without accessing the Cigna Cost of Care Estimator
                                                                     remaining amount due from patient                                                                may result in overpayment and require a refund to the patient

                                                                                                                                                                                                                  WWW.CIGNA.COM
                                                                                                                                             2        Client
                                                                                                                                                       logo            You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                                                                                                                       You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
                                                                           Legal entity name              5                                                       12   INPATIENT ADMISSION:
                                                                                                                                                                       Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
                                                                           Coverage effective date: MM/DD/CCYY         7           HMO (or POS)
                                                                                                                                                                       for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
                                                                           Group: 1234567                                           PCP visit          $15
                                                                                                                                                                       primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                                                           Issuer (80840)                                           Specialist         $15
                                                                                                                                    Hospital ER 4      $50             Med group: Sunset Med Group
                                                                           ID: U23456789 01 1                                                                          Send claims to: 123 Main Street, Suite 999, Anytown, USA 12345-678       13
                                                                                                                                    Urgent care        $25
                                                   HMO or POS

                                                                           Name: John Public                                        Vision             Yes             For pharmacy: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                           PCP: John Smith 8                                        Rx          41/$20/$40             For vision: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)          bn
                                                                           PCP phone: XXX-XXX-XXXX                                  Rx indiv deduct    $50
                                                                           ID card acct name 10                                                                        Cigna: PO Box XXXXX, Anytown, USA 12345-6789
                                                                                                                                    Coinsurance applies 3
                                                                           RxBIN Rx Bin RxPCN Rx Contr
Managed Care Plans: Primary Care Physicians

                                                                                                                  NSP
                                                                           DOI                                    logo       9
                                                                                                                                                                                                                                                                                                    C
                                                                                                         Network Savings Program                           Cat#
                                                                                                                                                                       Member services: 1.800.XXX.XXXX
                                                                                                                                                                                                                bo
                                                                                                                                                                                                                 MH/SA: 1.800.XXX.XXXX

                                                                •    PCP selection required
                                                                •    Referrals required
                                                                •    HMO: In-network coverage only, except emergency care
                                                                •    POS: Offered as an HMO or Network plan; in-network and out-of-network coverage

                                                                                                                 18                                                                                                   WWW.CIGNA.COM
                                                                             TPV logo
                                                                                             bl
                                                                                            11      CSN logo
                                                                                                                                            2        Client         You may be asked to present this card when you receive care. The card does not guarantee coverage. You must comply with all
                                                                                                     Cigna
                                                                                                  Care Network
                                                                                                                  6                                   logo          terms and conditions of the plan. Willful misuse of this card is considered fraud.

                                                                            Legal entity name       5                                                             12INPATIENT ADMISSION:
                                                                                                                                                                    Your provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents for your
                                                                            Coverage effective date: MM/DD/CCYY
                                                                                                                         7           Network
                                                                                                                                                                    pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
                                                                            Group: 1234567                                                                          care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                                                            Issuer (80840)                                           PCP Visit      $15/$20
                                                                            ID: U23456789 01
                                                                                                                                     Specialist  4  $15/$20            For information about mental health services and coverage, call MHSA Stmt Tel
                                                                            Name: John Public       1                                Hospital ER        $50            Med Group: Sunset Med Group
                                                                            PCP: James Smith
                                                                                                                                     Urgent Care        $25            Send claims to: 123 Main Street, Suite 999, Anytown, USA 12345-6789 13
                                                   Network

                                                                                 PCP Name Ln2       8                                Vision             Yes            For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                                                                                     Rx $10/20%/40%/100%               For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                            PCP Phone: XXX.XXX.XXXX                                  Rx Indiv Deduct    $50            Cigna Claims: PO Box XXXX, Anytown, USA 12345-6789
                                                                            ID card acct name       10                                                                 TPV Name, PO Box XXXX, Anytown, USA 12345-6789
                                                                            RxBIN XXXXXX RxPCN XXXXXXXX logo    NSP          9       Coinsurance applies      3        CSN Name, PO Box XXXX, Anytown, USA 12345-6789
                                                                            DOI                        Network Savings Program                             OAP#        Customer Service: 1.800.XXX.XXXX 14     bo MH/SA: 1.800.XXX.XXXX

                                                                • PCP selection required
                                                                • Referrals required
                                                                • In-network coverage only, except emergency care

                                              65
CSN logo       18                                                                                                      WWW.CIGNA.COM
                                  TPV logo          11                                                    Client             You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                            Cigna
                                                         Care Network   6                                  logo              You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.

                                 Legal entity name 5                                                                      12 INPATIENT ADMISSION AND OUTPATIENT PROCEDURES:
                                                                                                                             Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
                                 Coverage effective date: MM/DD/CCYY           7          PPO                                for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
                                 Group: 1234567                                             Dr. visit     $10/$25            primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
 PPO or EPO Plans

                                 Issuer (80840)                                             Specialist    $10/$25
                                                                                            Hospital ER        $50
                                 ID: U23456789 01 1
                                                                                            Urgent care
                                                                                                         4     $25              For pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                 Name: John Public                                          Vision             Yes              For vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                                            Rx          $10/20/30               Send claims to:
                                 ID card acct name       10                                 Network coinsurance:                CAD name, PO Box XXXX, Anytown, USA 12345-6789 13
                                                                                            In
                                 RxBIN XXXXXX RxPCN XXXXXXXX                                Out
                                                                                                     3 90%/10%
                                                                                                         70%/30%
                                                                                                                                TPV name, PO Box XXXX, Anytown, USA 12345-6789
                                                                        NSP                                                     All others: PO Box XXXX, Anytown, USA 12345-6789
                                 DOI                                               9        Med/Rx deductible applies
                                                                        logo
                                                                                                               Cat#
                                                                                                                                Customer service: 1.800.XXX.XXXX        14MH/SA: 1.800.XXX.XXXX                    15               AWAY FROM HOME CARE
                                                                Network Savings Program

                      •     No PCP selection required
                      •     No referrals required
                      •     PPO: In-network and out-of-network coverage
                      •     EPO: In-network coverage only, except emergency care

                                                                                                                                                                            WWW.CIGNA.COM
                                   TPV / Alliance
                                       logo         11                                       CareLink      Client            You may be asked to present this card when you receive care. The card does not guarantee coverage.
                                                                                               logo         logo             You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.

                                 Legal entity name 5
                                                                                                                          12 INPATIENT ADMISSION:
                                                                                                                             Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
                                 Coverage effective date: MM/DD/CCYY               Open Access Plus                          for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
                                                                                     No referral required
Strategic Alliances

                                 Group: 1234567                                                                              primary care doctor as soon as possible for further assistance and directions on follow-up care within 48 hours.
                                 Issuer (80840)
                                                                    7                PCP visit          $15
                                 ID: U23456789 01 1                                  Specialist    4 $30                        Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
                                 Name: John Public                                   Hospital ER        $50               13 For pharmacy: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                                     Urgent care        $25                     For vision: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                 PCP: John Smith
                                                                                     Vision             Yes                     Send claims to: CSN name, PO Box XXXXX, Anytown, USA 12345-6789
                                      PCP name Ln2
                                                                                     Rx $10/$20/$40/90%
                                 PCP phone: 860.555.1212                                                                        All other: PO Box XXXXX, Anytown, USA 12345-6789
                                                                                     Rx indiv deduct $50
                                 ID card acct name 10                                Network coinsurance: 3                     Customer service: 1.800.XXX.XXXX 14MH/SA: 1.800.XXX.XXXX
                                                                       NSP 9
                                 RxBIN XXXXXX RxPCN XXXXXXXX logo                    In            90%/10%
                                 DOI                         Network Savings Program                     Cat#                   We encourage you to use a PCP as a valuable resource and personal health advocate. 15               AWAY FROM HOME CARE

                          • PCP selection encouraged

                                                                                                                                                                                WWW.CIGNA.COM
                                                                                                         Client              You may be asked to present this card when you receive care. The card does not guarantee coverage. You must comply with all
                                                                                                          logo               terms and conditions of the plan. Willful misuse of this card is considered fraud.
                                                                                                                          12 INPATIENT ADMISSION:
                                Legal entity name 5                                                                          Your provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents for your
                                                    5
                                Coverage effective date: MM/DD/CCYY            7          Indemnity                          pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
                                Group: 1234567                                              Rx $10/20%/40%/100%              care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
                                Issuer (80840)                                              Rx indiv deduct    $50
Indemnity Plans

                                                                                            Indiv deduct     $300               Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
                                ID: U23456789 01 1                                          Family deduct    $500
                                                                                                                      3
                                                                                                                             Note: You can reduce your out-of-pocket expenses if you use a Network Savings Program provider. Use of a Network Savings
                                Name: John Public   1                                       Hospital deduct $200             Program provider does not affect your benefit coverage. For help finding a participating provider, please visit our website, or call
                                                                                            ER deduct          $50           the toll-free number listed on this card.
                                                                                            Coinsurance:
                                ID card acct name        10                                 Medical       80%/20%         13 For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                                                                                             For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
                                                     bk
                                RxBIN XXXXXX RxPCN XXXXXXXX             NSP                Med/Rx deductible applies            Send Claims to: PO Box XXXX, Anytown, USA 12345-6789
                                                                        logo       9
                                DOI
                                                               Network Savings Program                            Cat#          Customer Service: 1.800.XXX.XXXX        14MH/SA: 1.800.XXX.XXXX

                          • No PCP selection required
                          • No referrals required
                          • Patient files claims

                                                                                                                                                                                                                                                                    67
MORE WAYS TO ACCESS PATIENT
INFORMATION WHEN YOU NEED IT

USE OUR ELECTRONIC TOOLS
• Log in to the Cigna for Health Care Professionals website (CignaforHCP.com)
• Connect to us through electronic data interchange (EDI): visit Cigna.com/EDIVendors to learn more
• Call our automated phone system 1.800.88Cigna (882.4462)

CONDUCT ADMINISTRATIVE TRANSACTIONS ELECTRONICALLY
Cigna’s convenient eServices tools help you manage the administrative details of health care.
• Access patient eligibility and benefits
• Estimate patient out-of-pocket costs
• View and submit precertification requests
• Check claim status
• Enroll online for electronic funds transfer (EFT), then view, print, and share online remittance reports the
  same day you receive electronic payments
• Receive electronic remittance advice and automatically load it to your accounts receivable system
• Submit questions about fee schedules and specific patient benefits

LEARN MORE
To access our educational resources, log in to CignaforHCP.com > Resources > eCourses for courses about EDI,
eligibility & benefits, estimating patient out of pocket costs, precertification, electronic claim submission,
claim status inquiry, enrolling in and managing EFT, online remittance reports, and more.

Cigna,” the “Tree of Life” logo and “GO YOU” are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and
its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating
subsidiaries include Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, and HMO or service company subsidiaries of
Cigna Health Corporation.
591795 r 2014-256 06/14 © 2014 Cigna. Some content provided under license.
You can also read