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March 2011

INTEGRATION UPDATE

Integration Updates

Network Differences

CIGNA is taking a staged approach to integrating the CIGNA and GWH-CIGNA networks. Until further notice, CIGNA will maintain a separate network, including different contractual relationships with ancillary vendors, for individuals who have ID cards that include “GWH-CIGNA” in the upper right corner.

Services you provide to individuals with the GWH-CIGNA ID card are considered in-network if:

  • You have a provider agreement that identifies a Great-West Healthcare company
  • You have been notified in writing that individuals covered under plans formerly administered by Great-West Healthcare are now covered under your CIGNA participating provider agreement

 

Services you provide to individuals with the CIGNA ID card are considered in-network if:

  • You have a provider agreement that identifies Connecticut General Life Insurance Company or a CIGNA HealthCare HMO

CIGNA maintains different referral and service channels for each network. The ID card will identify the correct channels.

Ancillary Vendor and Facility Referrals

Contractual relationships with ancillary vendors vary by network. Referring your patients with CIGNA-administered coverage to facilities and health care professionals participating in the network associated with their plan can help ensure your CIGNA patients maximize their benefits and minimize their out-of-pocket expense.  

When making referrals, access our online directories to find participating facilities:

Claim and Service Channels

Each CIGNA network has a separate claim address/submission process, payer ID number, precertification procedure, and Customer Service number. The patient ID card will direct you to the correct information. 

Revised GWH-CIGNA ID Cards

Beginning in May, you will notice changes to newly issued GWH-CIGNA ID cards. The revised cards will include the following changes:

  • Rx ID number added to front of card
  • Customer service number and claim addresses will move to the back of the card
  • Customer website will appear in a blue bar on the left side of the card; the health care professional website will remain on the back of the card. 

These changes are being made to meet National Council for Prescription Drug Programs (NCPDP) and state-specific requirements. Currently 26 states have adopted NCPDP standards, while others have state-specific requirements. For example, Texas requires that additional copays be listed on the card, including the diabetic copay. North Carolina requires a bar code on the front of the card. Newly issued cards to customers in states with additional requirements will show those changes.

 

The GWH-CIGNA network indicator will continue to appear in the upper right corner of all GWH-CIGNA ID cards.  

Brand Changes

The Great-West Healthcare name and logo have been removed from most printed and electronic communications, as follows:

  • All electronic data interchange (EDI) transactions for your patients with GWH-CIGNA ID cards no longer include the “Great-West Healthcare” name.
  • The ERA payers previously shown as “GreatWestHealthcare-CIGNA” now displays “GWH-CIGNA” as the payer name. You may also see the CIGNA logo on the ERA depending on the vendor you use.
  • All other EDI transactions, including eligibility and benefits response (271) and claim status response (277) include the CIGNA name. The company name, “GreatWestHealthcare-CIGNA,” has been replaced with “GWH-CIGNA.” 

Please continue to submit all EDI transactions for your patients with GWH-CIGNA ID cards to 80705.

 

Content

   

Featured Article

Policy Updates

Electronic Tools

 

Pharmacy Updates

Integration Updates

General Updates

Helpful Reminders

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