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Home Providers Coverage and Claims Submit a ClaimElectronic Data Interchange Vendors

Electronic Data Interchange Vendors

Automate your claims process and save

Filing paper claims can be time consuming. When you submit claims to Cigna HealthcareSM 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.

Cigna Healthcare offers a direct connection implementation process for any provider, clearinghouse, billing service, or other EDI vendor (collectively "EDI Vendor") willing to connect to Cigna Healthcare without charging Cigna Healthcare for EDI transactions. In order to be considered for such an arrangement, EDI Vendors must be EHNAC HNAP-EHN accredited and CAQH Core Certified for the relevant EDI transactions. However, certification is not a guarantee of acceptance, there are other factors we must consider.

Email EDIConnectionRequest@Cigna.com for more information.

Offers are subject to change. Please contact the vendor directly for details.

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)
*Availity gateway services
X
 
X
 
Change Healthcare
X
 
X
X
Eligible Inc.
   
X
 
Experian Health, Inc.
X
 
X
X
Instamed
X
 
270/271 Only
 
NantHealth
   
X
 
Office Ally
X
 
X
 
PNT Data
X
 
X
X
SSI Group
X
X
X
 
TransUnion Healthcare, Inc.
   
270/271 Only
 
Trizetto Provider Solutions - Claim Logic
X
     
Trizetto Provider Solutions - Gateway EDI
X
 
270/271 Only
 
Waystar Health (formerly ZirMed or Navicure) 1 (844) 6WAYSTAR
X
 
X
 

*The Availity portal is not available for any Cigna Healthcare transactions

Dental EDI Vendors
Claim (837) Remittance (835)
Claim Attachments (275)
Eligibility Benefits and Claim Status Inquiry (270/271, 276/277)
Precertification / Authorization (278)
Change Healthcare
X
X
X
 
DentalXChange
X
X
X
 
NantHealth
   
X
 
Office Ally
X
 
X
 
PNT Data
X
 
X
 
Tesia
X
     
Trizetto Provider Solutions - Claim Logic
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 .

Change Healthcare (dental only)
Change Healthcare offers Dental Connect, a web-based application suite that will enable you to electronically submit claims, along with other health care transactions, directly to our national clearinghouse for processing, even if you don't have a practice management system. This can help your dental practice to:

  • Eliminate postage, printing, and envelope costs associated with paper claim submission
  • Improve staff efficiency through automated notification of claim receipt, status, and payment
  • Improve cash flow and outstanding receivables
  • Submit claims, claim attachments, and eligibility requests electronically
  • Access eligibility with detailed benefit descriptions

Bundled pricing starts at $19.95 per month. To register, go to Dental.ChangeHealthcare.com. Click Register for Dental Connect, and follow the registration prompts. Enter the Promotional Code "CIGNA2020" on the Manage Account page after you create an account. For more information, or if you have questions about the registration process, contact the Change Healthcare Dental Support team at 866.777.0713

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 (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 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 860.257.2030 to learn more.


More in Claims

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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.

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Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (“LINA”) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (“NYLGICNY”) (New York, NY), formerly known as Cigna Life Insurance Company of New York. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna.

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