External Entity Management Program
High standards across the board
The External Entity Management Program applies to those suppliers or entities performing specific services on Cigna’s behalf. The goal of the External Entity Management Program is to ensure that our customers, members, and/or providers receive a comparable level of service, as though received from Cigna directly.
If an entity or supplier's services fall under one of the following categories this higher level of supplier management will apply.
This policy applies to:
- Delegated healthcare provider arrangements (e.g., claim, utilization management, credentialing, provider/member appeals)
- National or regional specialty provider arrangements (e.g., home health care, radiology, lab)
- Third-party administrator arrangements, shared administration arrangements
- Outsourced business processes or functions.
This policy does not apply to:
- Traditional direct contracts with physicians, non-physician providers, ancillary providers, retail pharmacies or facilities
- Legal-related services
- Financial audit services
- Broker/producer relationships
- Persons or entities retained by the Cigna Board of Directors or any of its committees
- Outsourced functions that do not affect key stakeholders (e.g., food service, security guards)
External entity management standards
At a minimum, external entities within the management of this program should expect:
- Execution of confidentiality agreement
- On-site visit and due diligence activities prior to contracting
- Risk assessment activities
- Contract negotiation with involvement of Cigna Sourcing and Legal professionals
- Creation, implementation and monitoring of performance metrics
- Minimum annual review of relationship
If you have any questions on how your entity may be impacted by this program please contact the External Entity Management team at ExternalEntityManagement@Cigna.com.