Cigna Commercial pharmacy plans are in transition to adjudicate on the Express Scripts system in a phased approach. Most Cigna clients will transition on their benefit plan renewal date on or after February 1, 2020.
As of January 1, 2020 all Cigna HealthSpring Medicare claims are adjudicating on the Express Scripts platform.
BIN and PCN Codes
Commercial claims will continue to process utilizing the old BIN/PCN noted below until the group is transitioned to the Express Scripts system. Group numbers that have been transitioned can be found on the Pharmacy Resource Center.
If Commercial claims are submitted for groups that have transitioned with the old BIN or PCN, claims will reject with NCPDP Reject Code 01 (M/I BIN) and 04 (M/I Processor Control Number) with additional messaging providing the new BIN/PCN.
Please do not turn the customer away if you receive a rejected claim. Have them call the phone number on the back of their Cigna ID card. When applicable, the Pharmacy Providers should update impacted members' profiles with the new processing information.
| Name | New BIN | New PCN (Transitioned Group) | Payer Sheets | Old BIN | Old PCN |
|---|---|---|---|---|---|
| Cigna Pharmacy Services (Commercial) | Ø17Ø1Ø | 0215COMM | Payer Sheet 02150000 | Ø17Ø1Ø | Ø215ØØØØ |
| Cigna International | Ø17Ø1Ø | 0216INTL | Payer Sheet 02160000 | Ø17Ø1Ø | Ø216ØØØØ |
| GWH Cigna Commercial | Ø17Ø1Ø | 0518GWH | Payer Sheet 05180000 | Ø17Ø1Ø | Ø518ØØØØ |
| Cigna Payer Solutions | Ø17Ø1Ø | 0519PAYR | Payer Sheet 05190000 | Ø17Ø1Ø | Ø519ØØØØ |
Beginning on 1/1/2020, all Cigna HealthSpring Medicare claims will adjudicate on Express Scripts platform.
| Name | New BIN | New PCN | New RxGroup # | Old BIN | Old PCN | Old RxGroup # |
|---|---|---|---|---|---|---|
| Cigna HealthSpring® Medicare Prescription Drug Plans (PDP) | Ø17Ø1Ø | CIMCARE | CIGPDPRX | Ø17Ø1Ø | CIHSCARE | Not applicable |
| Cigna HealthSpring® Medicare Advantage Plan (MAPD) | Ø17Ø1Ø | CIMCARE | CGMAPDRX | Ø17Ø1Ø | CIHSCARE | Not applicable |
| Cigna HealthSpring® Medicare Employer Group Waiver Plan (EGWP) | Ø17Ø1Ø | CIMCARE | Please see Member ID Card | Ø17Ø1Ø | CIHSCARE | Not applicable |
| Leon Cares HMO® (MAPD) | Ø17Ø1Ø | CIMCARE | CGLEONRX | Ø17Ø1Ø | CIHSCARE | Not applicable |
| Cigna HealthSpring® Arizona HMO (MAPD) | Ø17Ø1Ø | CIMCARE | CIGNAZRX | Ø17Ø1Ø | CIHSCARE | Not applicable |
| Cigna-HealthSpring® Texas Medicare-Medicaid Plan (TXMMP) | Ø17Ø1Ø | CIMCARE | CGMAPDRX | Ø17Ø1Ø | CIHSCARE | Not applicable |
| Cigna-HealthSpring® Medicaid | Ø17Ø1Ø | CIMCAID | ZR3A | Ø17Ø1Ø | CIHSCAID | Not applicable |
Once transitioned, claim submissions will utilize the Express Scripts networks. Visit the Pharmacist Resource Center.
For copies of Express Scripts payer sheets and provider manuals, or to download Authorization Form 835, visit our Pharmacy Resources.
Pharmacies wishing to join our pharmacy networks, make demographic changes, request835 electronic remits, and more, please visit our Pharmacy Resources or ESIprovider.com for more information.