Durable medical equipment (including orthotics and prosthetics), home health, and home infusion As of February 1, 2021, eviCore healthcare (eviCore) manages home health care, durable medical equipment (DME), and home infusion therapy for Cigna commercial customers. Please call QualCare Provider Relations at 800.992.6613 if you have any questions or concerns. General Information: Provider Customer Service: 1 (800) 230-6138 Provider Website: MedicareProviders.Cigna.com Provider Manual: 2022 Provider Manual [PDF] ID Card Examples: 2022 Provider Manual [PDF] > Customer Identification Cards Provider Portal: HSConnectOnline.com Help Desk: 1 (866) 952-7596 Email: HSConnectHelp@HSConnectOnline.com ICD-10 Coding & Documentation/ For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico. Medicare and commercial manuals 2022 Provider manual for physicians, hospitals and healthcare providers - effective March 15, 2022 2022 Provider manual for physicians, hospitals and healthcare providers - delegation - effective March 15, 2022 2023 Provider manual for physicians, hospitals and healthcare providers - effective March, 1 2023 Network Insider Medicare Provider Newsletter, Provider Portal Claimstat Login Arizona Providers Only, www.eviCore.com/Resources/Healthplan/Cigna-Medicare, www.eviCore/com/Provider/Clinical-Guidelines. Use our self-service guidance and support form to easily find answers and resources for the most common inquiries. Privacy Policy | ka[|Ku@,OK"5HwC8UR10w%oF~O>?q8P y|Qge?6N$i@5@)Q \hRC-$J2RpjnPpS=ud7ofT& *FQQe^ afsTOln7ePX5@bGpF]$J\[R^5s=>nfL4f]_I>-!R|79@[Z6PVpd1*%FW0TCBGWP4|! endobj Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see Please click here to register for an account. Read our quick-reference guide (PDF) Network participation criteria We have a set of criteria for participation in our provider network. wont be able to apply to eviCore openings. Other names or logos may be trademarks of their respective owners. Report Fraud & Abuse | Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (LINA) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (NYLGICNY) (New York, NY), formerly known as Cigna Life Insurance Company of New York. All material on this website is, unless otherwise stated, the property of eviCore healthcare. As a valued user of our website, wed appreciate your feedback to help us improve your website experience. 1 (800) 668-3813 (TTY 711) 8:00 am 8:00 pm your local time, 7 days a week (Messaging service used weekends, after hours, and Federal holidays from . hb``b``Ab,nF )H\g```h i~ a,g}]Ig]7 1fq61` v T ob!!|Fy JC Good health and a good doctor/patient relationship begins with understanding your patients' cultural, ethnic, racial and linguistic needs. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna. For Cigna Medicare membership guidelines click here. 1 0 obj Cigna Medicare Advantage Plans . hb```, cb@1FFAA/j8Dcj29vPh Cookies are not enabled, for best results please enable cookies. %%EOF 0 These guidelines are not intended to supersede or replace sound medical judgment, but instead should facilitate the identification of the most appropriate imaging procedure given the individual's clinical condition. Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see IMPORTANT: In the coming days, we will be migrating systems for our Visit the Provider Portal at HSConnectOnline.com. To order eviCore-provided services for your patients with Cigna-administered coverage, contact a participating provider. For additional information about the Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service reimbursement policy please watch this brief video. %-NM .t|p[!U"thV6I>sHH{[;:B#N v',(M=a!bHJ. hbbd```b`:" l,3!V "@|j0$> 0L[+&00Fr G(9J'(9Ft5JJgx s To search the Prior Authorization guide for a code, enter Ctrl+F > the 5-digit code. This website is not intended for residents of New Mexico. 5281 0 obj <>stream Medicare patients' claims must be filed no later than the end of the calendar year following the year in which the services were provided. Medicare patients' claims must be filed no later than the end of the calendar year following the year in which the services were provided. CHCP - Resources - Medical Reference Guides Commercial Medical Reference Guides Medical Reference Guides Here you'll find reference guides to help make it easier for health care professionals to do business with Cigna. 3269 0 obj <>/Filter/FlateDecode/ID[<2E60FC638041A04290D8E725F3905F1C>]/Index[3250 28]/Info 3249 0 R/Length 99/Prev 521572/Root 3251 0 R/Size 3278/Type/XRef/W[1 3 1]>>stream Provider customer service 1.800.230.6138 Provider website MedicareProviders.Cigna.com Provider manual MedicareProviders.Cigna.com > 2023 Provider Manual ID card examples MedicareProviders.Cigna.com > 2023 Provider Manual > 2023 Customer Identification Cards Provider portal HSConnectOnline.com Help Desk: 1.866.952.7596 Email: HSConnectHelp@ Provider Customer Service: 1 (800) 230-6138, Provider Website: MedicareProviders.Cigna.com, Provider Manual: 2022 Provider Manual [PDF], ID Card Examples: 2022 Provider Manual [PDF] > Customer Identification Cards, Provider Portal: HSConnectOnline.comHelp Desk: 1 (866) 952-7596Email: HSConnectHelp@HSConnectOnline.com, ICD-10 Coding & Documentation/360 Comprehensive Assessment:Provider Education and Assessment Tools, Quest Diagnostic LaboratoriesCall: 1 (866) 697-8378. Q4: How can eviCore make it easier for you to use this website? 58 0 obj <> endobj 6T O'@j8*r', ;#Na-16|=i8IO_K$ _v:s+)"{%#YdQA=2A`,?6P~<4?EE`GD*8j 5pg, =dn/G~5i/!,A1R5n12&A{@ &`" _X)Z$K:PQ84H&TiXh|eOJDK E@0Rkg,_c"3?KpmJT. %%EOF CocoDoc has made it easier for people to Modify their important documents by online browser. Message Here. hd|(3bECB!_,BM@2sjn&+_C+S3 kg|N0=8fx8P T! As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, Browse Medical Resources Medical Reference Guides Here you'll find reference guides to help make it easier for health care professionals to do business with Cigna. 0 From professional newsletters to wellness programs to Cigna medical plans and more, this is the medical health care professional's source for information. To learn more about a program, or request a patient eligibility evaluation, email CignaRefer_Help@Cigna.com. 3 0 obj eviCore has a national network of providers who offer these services. Member Rights Policy | All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. a listing of the legal entities Annual Utilization Statistics | An initial determination on a previously adjudicated claim may be reopened for any reason for one year from the date of that determination. To make updates , please notify QualCare Provider Relations. vaccine, please review our . endstream endobj startxref Coverage determinations in each specific instance require consideration of: eviCore's guidelines are based upon major national and international association and society guidelines and criteria, peer-reviewed literature, major treatises, and input from health plans, practicing academic and community-based physicians. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only. Clinicians are expected to use independent medical judgment which takes into account the clinical circumstances to make individual management decisions. If you have any questions or would like more information about participating in a Cigna health care network, please contact us. eviCore's clinical guidelines are evidence-based and apply to the following categories of service for individuals with Cigna-administered plans: The terms of an individual's particular coverage plan document [Group Service Agreement (GSA), Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD), or similar plan document] may differ significantly from the standard coverage plans upon which these guidelines are based. Ethics & Compliance | a listing of the legal entities However, the filing limit is extended another full year if the service was provided during the last three months of the calendar year. April 1 - September 30) Cigna Medicare Advantage Plans (Arizona Only) 1 (800) 627-7534 (TTY 711) 8:00 am 8:00 pm Mountain time, 7 days a week Cigna contracts with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans (PDP) in select states, and with select State Medicaid programs. eviCore's clinical guidelines are evidence-based and apply to the following categories of service for individuals with Cigna-administered plans: Computed Tomography (CT) and Computed Tomography Angiography (CTA) Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) Positron Emission Tomography (PET) Nuclear Cardiology