Electronic Data Interchange Vendors
Automate your claims process and save
Filing paper claims can be time consuming. When you to submit claims Cigna Healthcare℠ electronically, including coordination of benefits (COB) claims, your practice can gain many benefits such as:
- Quicker claims submission, including Dental Health Maintenance Organization (DHMO) network claims
- Faster payments
- Improve claims accuracy - reduce transcription errors and missing data
- No printing and mailing costs
- Spend less time resubmitting corrected claims
- Reduce paperwork
- 24/7 access to claims tracking
- Lower operational costs
- Fewer rejections and resubmissions
- Faster responses and payment
These electronic data interchange (EDI) vendors1 securely transmit data electronically to Cigna Healthcare. See below for special offers.
Offers are subject to change. Please contact the vendor directly for details.
- 1
EDI vendor information is as of 09/01/2020 and is subject to change. Any reference to the products, services, information or websites of any non-Cigna Healthcare-affiliated entity is provided for informational purposes only. Cigna Healthcare does not endorse or guarantee the products, services, information, or websites of such entities
| Medical and Behavioral EDI Vendors | Claim (837) Remittance (835) | Claim Attachments (275) | Eligibility Benefits and Claim Status Inquiry (270/271, 276/277) | Precertification/Authorization (278) |
|---|---|---|---|---|
| X | ||||
| X | X | |||
| X | X | X | ||
| X | ||||
| X | X | |||
| X | X | X | ||
| X | X | X | ||
| X | ||||
| X | 270/271 Only | |||
Waystar Health (formerly ZirMed or Navicure) | X | X |
To learn more about Cigna Healthcare Medicare Advantage electronic data interchange vendors and transactions, see pages 13-15 of the Participating Provider Manual [PDF].
| Dental EDI Vendors | Claim (837) Remittance (835) | Claim Attachments (275) | Eligibility Benefits and Claim Status Inquiry (270/271, 276/277) | Precertification/Authorization (278) |
|---|---|---|---|---|
| X | X | X | ||
| X | ||||
| X | X | X | ||
| X | ||||
| X | X | |||
| X | X | |||
| X | 270/271 Only | |||
| X |
Special Offers
Unless otherwise specified, the special features and offers described are available for medical, dental, and behavioral providers.
ABILITY Network If you currently submit 100 percent of your claims to Cigna Healthcare on paper, and agree to convert to electronic claims submission, you may be eligible to submit claims electronically for free. You may also qualify for special offers on all payer solutions. For more information, go to mdol.com/Cigna or call 1 (888) 499-5465.
DentalXChange’s ClaimConnect is the premiere EDI solution for online dental claims delivery and real-time services. This user-friendly platform processes dental insurance claims, sends attachments and retrieves eligibility and benefits, quickly and easily. With ClaimConnect you get state-of-the-art technology coupled with superior customer service, offering you the perfect solution for all of your EDI dental claims needs.
- Easily send claims with or without a Practice Management System
- Instant claim validation for accuracy
- Online claims editing and management tools
- Submit electronic attachments using custom rules for your providers
- Requires no additional third-party software
- Eligibility and Plan Benefits in seconds
- On line ERA/EOB display and print capability
To learn more about DentalXChange and Cigna Healthcare incentives to move to electronic, please visit www.DentalXChange.com or call 1 (800) 576-6412 (ext. 455)
Office Ally For providers who don't have an EDI-capable system or are simply looking for a low cost clearinghouse, Office Ally offers an on line claim entry tool, a free Practice Management System and the ability to upload claims from your current practice management software. Free unlimited training and onshore support is available 7 days a week. Enroll online at OfficeAlly.com or call 1 (360) 975-7000, option 3.
PNT Data offers a secure and easy-to-use tool for providers to submit electronic Claims directly to Cigna Healthcare for free – please note: you must be able to create an electronic ANSI x12 837 format to use our system. Our bi-directional service model delivers Claims, Remits and other related transactions directly to the recipient with quick and accurate validation and confirmation, helping to resolve issues faster. Submission through PNT Data can give your organization tremendous value.
- Lower administrative and operational costs
- Easier/faster remit reconciliation
- High-touch Customer Support
Additionally, by submitting claims through PNT you’ll have access to the PNT Portal at no additional cost. The Portal gives you the ability to monitor, track and run reports on submitted transactions 24x7. Our committed and friendly support team is eager to get you started today. Visit www.pntdata.com/enroll/ or call 1 (860) 257-2030 to learn more.