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 2/1/20; a limited number transitioned prior to 2/1/2020.
Beginning 1/1/2020, all Cigna HealthSpring Medicare claims will adjudicate on Express Scripts platform.
BIN and PCN Codes
Commercial Claims will continue to process utilizing the 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.
| 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 |
If Commercial claims are submitted for groups that have transitioned on or after 10/1/19 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.
When applicable update impacted member’s profiles with the new processing.
| Pharmacies requesting to participate in Cigna Networks, please use contact information below: | |
|---|---|
| Cigna Commercial Retail Networks |
Express Scripts Network Credentialing:
|
| Cigna Medicare Part D Network effective 1/1/20 |
Express Scripts Network Credentialing:
|
|
Once transitioned, claim submissions will utilize the Express Scripts networks, payer sheets and Provider Manuals. For copies of Express Scripts:
|
Visit the Pharmacist Resource Center |
Please do not turn the customer away if you receive a rejected claim. Please call the phone number on the back of the ID card.