Medicare Advantage
PROVIDER QUICK REFERENCE GUIDE

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General Information

Provider Customer Service:
1 (800) 230-6138

Provider Website:
MedicareProviders.Cigna.com

Provider Manual:
MedicareProviders.Cigna.com > 2021 Provider Manual

ID Card Examples:
MedicareProviders.Cigna.com> 2021 Provider Manual > Page 15

Provider Portal:
HSConnectOnline.com
Help Desk: 1 (866) 952-7596
Email:
HSConnectHelp@HSConnectOnline.com

ICD-10 Coding & Documentation/
360 Comprehensive Assessment:
MedicareProviders.Cigna.com > Provider Education

Ancillary Services/Supplemental Benefits

Outpatient Laboratory Services:

LabCorp
Call: 1 (888) 522-2677

Quest Diagnostic Laboratories
Call: 1 (866) 697-8378

Behavioral Health Substance Abuse (Authorizations)
Call: 1 (866) 780-8546
Fax: 1 (866) 949-4846
 
For questions concerning Supplemental Benefits, call Provider Customer Service: 1 (800) 230-6138

High-Technology Radiology and Diagnostic Cardiology

For precertification, clinical support or customer service, contact below or go online to Evicore.com.

Provider Resources:
Evicore.com > Resources > Healthplan > Cigna-Medicare

Web Portal Support:
Portal.Support@Evicore.com
Call: 1 (800) 646-0418

Clinical Support/Program
Inquiries:
Email: ClientServices@Evicore.com
Call: 1 (888) 693-3211
Fax: 1 (888) 693-3210

Clinical Guidelines:
Evicore.com > Provider > ClinicalGuidelines

Educational Materials:
Evicore.com > Resources > Healthplan > Cigna-Medicare

Medical Oncology and Radiation Therapy

For precertification, clinical support, or customer service, contact below or go online to Evicore.com.

Medical Oncology:
Call: 1 (866) 668-9250
Fax: 1 (800) 540-2406

Clinical Guidelines:
Evicore.com > Provider > ClinicalGuidelines

Radiation Therapy:
Call: 1 (866) 686-4452
Fax: 1 (866) 699-8128

Clinical Guidelines:
Evicore.com > Provider > ClinicalGuidelines

Educational Materials:
Evicore.com > Resources > Healthplan > Cigna-Medicare

Clinical Support/Program Inquiries:
Email: ClientServices@Evicore.com
Call: 1 (866) 686-4452

Web Portal Support:
Email: Portal.Support@Evicore.com
Call: 1 (800) 646-0418

Educational Materials: Evicore.com > Resources > Healthplan > Cigna-Medicare > Medicare Oncology FAQs

Musculoskeletal Procedures

For precertification, clinical support, or customer service, contact below or go online to Evicore.com.

Provider Resources:
Call: 1 (888) 693-3297
Fax: 1 (888) 693-3210
Send clinical questions/case examples to Evicore’s client
and provider service team

Clinical Guidelines:
Evicore.com > Provider > Clinical-Guidelines >Musculoskeletal: Advanced Procedures

Educational Materials:
Evicore.com > Resources > Healthplan > Cigna-Medicare

Clinical Support/Program Inquiries:
Email: ClientServices@Evicore.com
Call: 1 (866) 686-4452

Web Portal Support:
Email: Portal.Support@Evicore.com
Call: 1 (800) 646-0418

Prior Authorizations

For prior authorizations, access our interactive Prior Authorization Requirements (a searchable reference guide updated quarterly MedicareProviders.Cigna.com > Forms and Practice Support > Prior Authorization Requirements. To search the Prior Authorization guide for a code, enter Ctrl+F > the 5-digit code.

Find PA forms at MedicareProviders.Cigna.com > Forms and Practice Support > Prior Authorization Requirements.

To submit a Prior Authorization request:
Visit the Provider Portal at HSConnectOnline.com.
Electronically: Covermymeds.com
Fax: 1 (866) 845-7267
Phone: 1 (877) 813-5595

Referrals

HMO referrals vary by plan. PPO plan referrals are not required.
Referrals for specialists can be obtained through our HSConnect Provider Portal.
To register for HSConnect visit: HSConnectOnline.com/Login
To contact the HSConnect Help Desk call: 1 (866) 952-7596 | Email: HSConnectHelp@HSConnectOnline.com

Patient Evaluations

To evaluate patient eligibility for a patient support program, access our Patient Support Programs Quick Reference Guide at: MedicareProviders.Cigna.com > Forms and Practice Support

To learn more about a program, or request a patient eligibility evaluation, email CignaRefer_Help@Cigna.com.

Claims Processing

Claims questions: 1 (800) 230-6138 | Appeals questions: 1 (800) 511-6943 | Fax: 1 (800) 931-0149
Electronic claims may be submitted through:

  • Change Healthcare/Availity (Payor ID: 63092 or 52192)
  • SSIGroup/Proxymed/Medassets/Zirmed/OfficeAlly/GatewayEDI (Payor ID: 63092)
  • Relay Health (Professional claims CPID: 2795 or 3839, Institutional claims CPID: 1556 or 1978)

Paper Claims: Cigna Medicare Advantage, PO Box 981706, El Paso, TX 79998
Appeals: Cigna Medicare Advantage Appeals, PO Box 24087, Nashville, TN 37202
Reconsideration Requests: Cigna Medicare Advantage Reconsiderations, PO Box 20002 Nashville, TN 37202

Compliance

To report potential fraud, waste, or abuse please contact us in one of the following ways:

Mail:
Cigna Medicare Advantage
Attn: Special Investigations Unit
PO Box 20002, Nashville, TN 37202

Email:
SpecialInvestigations@Cigna.com
Attn: Cigna Medicare Operations

Phone: 1 (800) 667-7145

 

Pharmacy

Pharmacy - Part D

Prior Authorization Requests: Covermymeds.com (Preferred method)
Formulary Website: Cigna.com/medicare/resources/drug-list-formulary
Forms: Cigna.com/Medicare/Resources/customer-forms