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HealthCare Frequently Asked QuestionsClaim InformationClaim Information
How do I find out the status of a claim? You can request the status of a claim by calling the Customer service number on your CIGNA HealthCare ID card or click here to go to myCIGNA.com. How do I file a claim? For plans that have both in-network and out-of-network benefits, in-network claims don't require claim forms. When you see a network provider or go to the hospital, show your CIGNA HealthCare ID card so the provider knows to bill us. You only need to file a paper claim if you go to a non-participating provider and/or you require emergency or urgent care away from home. If you do receive a bill from the provider, review the bill to make sure it's not an "information only" statement. Most providers will send you a statement showing the total amount due and informing you they billed the health plan. If it is a bill, ask the provider if they've submitted the bill to CIGNA HealthCare. Most providers use systems-generated billing where their computer automatically sends out the bill. Providers belong to many different health plans and may not have billed us correctly. Out-of-network claims require a claim form. Claim forms can be obtained from your human resources department or online, Medical Claim form. Complete the form and send it to the claims address on your CIGNA HealthCare ID card. If you are enrolled in a traditional Medical plan you are also required to file a claim using a Medical Claim form. How can I get a claim form? Claim forms can be obtained from your human resources department or online, Medical Claim form. How long will it take to process my claim? Processing a claim through the claim system can take up to 14 business days from the date it is received. What happens if my claim was not received? Processing a claim through the claim system can take up to 14 business days from the date it is received. If the claims were mailed within the past four weeks, please allow more time for processing. If the claims were mailed more than four weeks ago, please resubmit the claim to the address located on your ID card. How do I appeal a claim that was denied? Please call the Customer Service number on your ID card to initiate an appeal. How do I read my Explanation of Benefits (EOB)? Please see our online sample EOB and an explanation. How can I get a copy of an Explanation of Benefits (EOB)? Please call the Customer Service number on your ID card to request an EOB. Why did I receive a bill in the mail? If you received a bill from a provider, review the bill to make sure it's not an "information only" statement. Most providers will send you a statement showing the total amount due and informing you they billed the insurance company. If it is a bill, ask the provider if they've submitted the bill to CIGNA HealthCare. Most providers use systems-generated billing where their computer automatically sends out the bill. Providers belong to many different health plans and may not have billed us correctly. |
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