Cigna Provider Credentialing Services
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What Makes Us Special?
Our Specialist Will Help You Get Enrolled with Cigna
Cigna Provide Enrollment Requirements
Applying for Cigna credentialing, you’ll need to go through a few processes. These include the following:
Get an NPI (National Provider Identification Number)
The National Provider Identifier (NPI) is a 10-digit number assigned to healthcare providers that electronically submit claims or other data. All health care professionals that perform electronic transactions must have an NPI, according to the Health Insurance Portability and Accountability Act. The National Plan and Provider Enumeration System is where you can apply for an NPI.
Verify that you have sufficient malpractice Insurance
Make sure your specialty’s malpractice insurance requirements are met in your state.
Fill Out A CAQH Profile
Cigna and a number of other insurance firms rely on CAQH technology to gather data and complete administrative duties. A CAQH profile can be completed online, although the procedure can take up to 2 hours. You must give Cigna permission to access your information.
Contact Cigna
Before you start the application process, call Cigna to make sure you meet the basic credentialing requirements.
Complete and Submit Your Application
Cigna will deliver you an application form via email if you match the requirements for credentialing. You can apply either online via CAQH or by mail to Cigna
In addition to your application, you must give Cigna the following information, whether you submit an application online or by mail.
- Medical license from the state
- If your state requires it, you’ll need a Controlled Dangerous Substances certificate
- Hospital clinical privileges participation
- Status of board certification
- Education and training for professionals
- Work experience
- Activities that were sanctioned previously
- Insurance for medical malpractice
- History of malpractice lawsuits
Keeping You Up To Date
We’ll begin the credentialing process once we get the application packet. It usually takes 45 to 60 days to finish this task. Throughout this time, you will get emails from us to the following addresses:
- Verify that your application has been received
- Any documentation or application information that is lacking should be requested. If we don’t receive the missing information, we’ll send an email notifying you that your application has been closed.
- Keep you informed about where your application is in the credentialing verification process, as well as any delays that may cause the process to take longer than the typical 45 to 60 days.
- Confirm whether you’ve been registered and credentialed as a network-participating provider, as well as your effective date, or let you know if you haven’t.
We will put your provider information into our directories and claim systems if you are accepted, which usually takes 10 working days.
To Check The Status Of Your Application?
If you’d want to know where your application stands in the process, go to:
- Please send an email to our account. Include your full legal name as well as your Taxpayer Identification Number.
- Alternatively, call and ask for credentialing
Welcome To the Cigna Network
Program for Re-credentialing
Before becoming a participating provider with Cigna, all practitioners and organizations must meet the basic eligibility requirements given to complete the credentialing procedure. After submitting an application, the provider must go through a thorough verification procedure that comprises primary and secondary source verifications of all pertinent information for the contracted specialty.
Providers are subjected to a peer review procedure after completing the verification process, which determines whether they are approved or refused membership in the plan. Without passing through the credentialing verification and peer review procedure, no provider can be issued a health plan effective date or be listed in a provider directory. To preserve participation status, all providers who were initially approved for participation must re-credential at least once every three years.
The process of re-credentialing encompasses, but is not restricted to:
Application evaluation
We double-check that you’ve completed all sections of the form and sent in all required attachments.
Credentials verification
We check and verify information such as the status of your license and malpractice insurance coverage, among other things. The Regional Network and Credentialing Committee (RNCC), which is made up of Cigna clinical personnel and professional peers, review re-credentialing. Re-credentialing applications and any supplementary information are reviewed by the RNCC.
You may get a notification letter after successfully completing the re-credentialing process. If you don’t hear anything, it’s safe to believe your credentials were confirmed.
FAQ! NEED HELP?
The Cigna provider enrollment is process through which insurance company verify healthcare
providers, such as doctors and facilities, are evaluated and verified for their qualifications,
experience, and ability to provide quality care to Cigna's members in the USA.
The healthcare provider enrollment with Cigna is important because it ensures that healthcare
providers meet specific standards and qualifications, which is essential for them to be eligible
for participation in Cigna's network and to receive payments for services rendered to Cigna
members in any state of the USA.
Stars Pro has an expert Cigna credentialing team, healthcare providers across the nation can
start the credentialing process by contacting our credentialing team or by just calling at 1-732-
523-4633, we will complete your Cigna enrollment process on priority basis.
Our medical credentialing specialists will take are required documents from yourself including
license verification, professional liability insurance information, educational history, your work
history, and references.
Stars Pro Cigna medical credentialing team complete your credentialing process in the minimum
time, usually Cigna credentialing process take 3 to 6 months. Our credentialing team highly
recommends healthcare providers to start the process well in advance of their desired
participation start date.
If a provider’s application is denied, they will typically receive an explanation outlining the
reasons for the denial. Our credentialing team then closely work with the provider to solve the
issue and resubmit the required document and properly appeal for they may have the
opportunity to appeal or reapply after addressing the issues.
Yes, healthcare providers must meet ongoing requirements, including regular re-credentialing,
to remain in Cigna's network. This ensures that they continue to meet quality standards.
Cigna provides resources and updates on their website and through their provider network
communication channels. Providers can also contact their Cigna representative for assistance.
Credentialing with Cigna allows providers to access a larger patient base, receive payments for
services rendered to Cigna members, and gain recognition as a trusted healthcare provider.
Channel Partners
Stars Pro® Medical Billing inventive model is one of the fastest growing physician practice communities in the United States. We are dedicated to lashing change in the medical community by providing progressive, state-of-the-art solutions. Through our Channel Partnerships.
Merritt Widen, MD
Catherine Antoine
Dr. Maria C Erazo
Dr. Loretta Oguonu
Jessica Sullivan
Dr. H. Okpala
Dr. Abordo
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Orthopedic Group
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