Cigna Provider Enrollment

Cigna Provider Credentialing Services

Cigna is a global healthcare insurance firm with policies for individuals and families in many regions. Accepting Cigna insurance as a health care provider in a place having Cigna plans can help you attract more patients, raise revenue, and improve your reputation. One must first have to go through Cigna credentialing procedure before getting Cigna insurance.

What Makes Us Special?

Cigna is honored to become one of the leading health-plan providers, focusing primarily on Medicare Advantage and other Medicaid and Medicare programmes. We’ve created a collaborative model that gives our members better access to high-quality preventive care while also providing physicians with the tools they need to deliver it. Before you join our team, it’s crucial to understand that our actions are guided by the following key principles. Before you say a single benefit, it’s your obligation to instill these values in every customer.

Our Specialist Will Help You Get Enrolled with Cigna

As a Cigna in-network provider, you will broaden your reach and be able to assist more patients. Despite its advantages, the credentialing process takes time and can be stressful when combined with your other responsibilities as a health care professional. You can avoid Cigna’s credentialing issues by working with us and leaving the complicated details to us. Contact us right away if you’re ready to begin the Cigna credentialing and registration process.

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

If Cigna validates a practitioner’s application, that practitioner joins Cigna’s network of providers. Within the next 10 business days, Cigna will update the provider information in their database. Member will get an email confirming your approval and stating your effective date if you are accepted and credentialed.

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.

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