HELPFUL PHARMACIST INFORMATION
Proof of Cigna-HealthSpring Rx prescription drug coverage
There are three valid forms of benefit coverage identification:
- Cigna-HealthSpring Rx ID card*
- Completed Enrollment Acknowledgement Letter
- CMS Confirmation Letter
Each contains the RxBIN and the RxPCN which are required to transmit claims to OptumRx for claims processing. For more about RxBIN, RxPCN and other pharmacy-specific information related to Cigna-HealthSpring, please visit our Pharmacy Management page.
Pharmacy Compliance Tools
Cigna-HealthSpring has developed materials to assist pharmacies with implementation of compliance elements such as training, conflict of interest review, and the exclusion review process. To learn more and to access our tools, visit our Compliance Training Tools page.
Best Available Evidence (BAE)
If you have questions on the CMS Guidance regarding Best Available Evidence, please see the CMS website.
Notice of Coverage Rights
CMS requires that all pharmacies provide Medicare members with the Notice of Coverage Rights upon the following NCPDP notifications:
NCPDP Approval Code 018
NCPDP Reject Code 569