PDF HealthPartners CIGNA Alliance
2014 Provider Resource Materials
HealthPartners CIGNA Alliance
01/2014
HealthPartners Confidential and Proprietary
15
2014 Provider Resource Materials
CIGNA/HealthPartners Strategic Alliance
Quick Reference Guide
To better serve our members, HealthPartners, Inc. and CIGNA have formed a strategic alliance making a national network available to HealthPartners and CIGNA employer groups and individual customers. The focus of this alliance is providing access to quality care and improving health through a comprehensive network.
What you should know: The alliance national network is comprised of the CIGNA Open Access Plus provider
network and the HealthPartners provider network. HealthPartners service area is Minnesota, North Dakota, Western Wisconsin and South
Dakota. CIGNA membership (including Behavioral Health) within the HealthPartners service area
will utilize the HealthPartners provider network (except in South Dakota). HealthPartners membership (including Behavioral Health and Transplant networks) will
utilize the CIGNA Open Access Plus provider network in areas outside the Minnesota,
North Dakota, Western Wisconsin and South Dakota service area. The key distinguishing factor in determining if the member is accessing the alliance
national network as a CIGNA member or HealthPartners member is the member ID card.
Sample ID card - CIGNA Plan Administration (Claims are submitted to CIGNA address on back of card)
CIGNA/HealthPartners logos Product Information Precertification Info Paper Claims address Customer Service Contact Numbers
Sample ID card?HealthPartners Plan Administration (Claims are submitted to HealthPartners address on back of card)
***These ID card samples are examples.
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HealthPartners Confidential and Proprietary
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2014 Provider Resource Materials
IF YOU WANT TO:
Perform the following online transactions: Verify patient eligibility and coverage Check the status of a claim Request precertification for services (CIGNA only)
View claim coding policies and
payment guidelines
USE THIS SERVICE FOR CIGNA RELATED INQUIRIES
USE THIS SERVICE FOR HEALTHPARTNERS RELATED
INQUIRIES
Review Administrative Information including:
Medical coverage positions Pharmacy formulary Update address information Quality and Quality Improvement
Programs Clinical Guidelines Utilization Management
Including: Financial Incentives Criteria Contact a Medical Director Member Rights and Responsibilities and Complaint processes and procedures Confidentiality Privacy
Perform the following electronic transactions:
Verify patient eligibility and coverage
Inquire about patient coverage and covered services
Check the status of a claim Request precertification for
services (CIGNA only) Submit claims electronically Receive electronic remittance
advice
CIGNA Managed Care and PPO Payer ID: 62308
CIGNA Medicare Advantage PFFS Payer ID: 86033
Post-N-Track
1.860.257.2030 Existing Clearinghouse or contact Emdeon
1.877.469.3263
HealthPartners has multiple options for electronic claims submission-Visit Provider and click "Explore Electronic Transactions (EDI)"
Perform the following through telephonic transactions:
Learn about electronic services Verify patient eligibility and
coverage Check the status of a claim Request precertification/prior
authorization services Check credentialing status Request an exception to the
prescription drug list
1.800.88CIGNA(882.4462)
1.800.883.2177
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HealthPartners Confidential and Proprietary
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IF YOU WANT TO:
Contact Provider Services or for general inquiries Submit a payment appeal
Submit a clinical appeal Transplants
2014 Provider Resource Materials
USE THIS SERVICE FOR CIGNA RELATED INQUIRIES
USE THIS SERVICE FOR HEALTHPARTNERS RELATED
INQUIRIES
1.800.88CIGNA(882.4462)
1.800.444.4558
Cigna National Appeals PO Box 188011
Chattanooga, TN 37422 1.800.88Cigna
Fax:1.877.815.4827
Refer to contact information on the authorization/denial letter
1.800.668.9682
1.800.444.4558
Refer to the contact information received on the authorization/denial letter 1.799.773.2177
01/2014
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