How Providers Can Join the CIGNA HealthCare Network

Application and Credentialing Steps for CIGNA Providers

Becoming a CIGNA HealthCare participating provider can be beneficial to the medical office and its physicians. CIGNA HealthCare is one of the largest health insurance companies in the US for individuals and families. As part of their network, your services will be used preferentially.

Advantages of Becoming a CIGNA Participating Provider

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Participating with CIGNA HealthCare offers the medical office several opportunities:

  • Become part of a global network of physicians and medical office practices known for meeting or exceeding quality and patient safety measures.
  • Access to CIGNA HealthCare members searching for a participating provider in your area.
  • Several practice management tools are offered online that allow the medical office to verify member eligibility and benefits, check claim status, estimate patient liability, submit requests for prior authorization, and access many more features.

Use the following steps as a guide to becoming a CIGNA HealthCare Participating Provider.

Step 1: Obtain a National Provider Identifier (NPI) and Other Identifiers

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Prior to applying for participation in CIGNA's HealthCare network, providers including physicians, other clinical professionals, medical office practices, and certain suppliers must obtain an NPI.

The National Provider Identifier or NPI is a 10-digit unique identification number required by HIPAA. If you do not already have an NPI, apply for one at nppes.cms.hhs.gov or call the NPI Enumerator at 1-800-465-3203.

You will also need a UPIN, Medicare Provider number, and Medicaid Provider number on hand to help you fill out the application, when applicable.

Step 2: Join CAQH Universal Provider Datasource (UPD)

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CAQH UPD is an online tool designed to simplify the process of gathering information required by health plans for provider credentialing. Members can complete and submit their information to many different health plans for free.

Obtain a CAQH Provider ID by calling the CAQH Support Desk at (888) 599-1771 or email caqh.updhelp@acsgs.com. Then login at upd.caqh.org/oas/ to follow instructions to complete and activate registration.

Step 3: Complete the Application for CIGNA

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After completing the prerequisites, call 1-800-88Cigna and take the Credentialing option. You will be sent the information needed for the application and credentialing.

The application process can be completed entirely online. Once the application is completed and attested, you will need to authorize CIGNA HealthCare to gain access to your enrollment application and other information. The entire process should take no longer than two hours to complete. The module is also designed to save your information if you need to complete the application in multiple sessions.

The CAQH support desk is available to assist you if you should need help during the process. You can also email psscentral@cigna.com

Step 4: Gather All Supporting Documentation for CIGNA

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Any applicable supporting documentation must be faxed to CAQH at (866) 293-0414. You will need:

  • Curriculum Vitae
  • Medical license
  • DEA certificate
  • CDS certificate
  • IRS Form W-9
  • Malpractice insurance fact sheet
  • Summary of any pending or settled malpractice cases

In addition to the information required by CAQH, CIGNA HealthCare has their own list of documents and/or supporting criteria that may be requested.

  • Verification of clinical privileges in good standing on the medical staff at a CIGNA-participating hospital
  • Board certification status with the American Board of Medical Specialties or the American Osteopathic Association
  • Verification of education and training
  • Verification of prior sanctioning activities by regulatory bodies and by CMS
  • CIGNA conducts on-site visit to PCPs, OB/GYNs, and high-volume behavioral health specialists

Other Pertinent Information for Becoming a CIGNA Provider

  • The entire process may take up to three to six months
  • Allow 60 from the decision date to receive the welcome letter
  • Depending on the physician or medical office specialty, information unique to your specialty may be requested in addition to the supporting documentation listed above
  • Re-credentialing occurs every three years
  • For more information about your medical office becoming a CIGNA HealthCare participating provider visit www.cigna.com and www.caqh.org

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