CIGNA has implemented the below claim submission rules for submitting newborn claims:
Subscriber information should be submitted with:
-Policyholder's CIGNA ID number without the suffix. (Suffix is the last two digits of the ID that determine the relationship to the policyholder, such as 01, 02, etc.)
-Policyholder's first and last name
Patient information should be submitted with:
-First name or "newborn," "baby boy," "baby girl," "twin A," etc.
-Newborn last name
-Newborn date of birth
Newborn claims that do not adhere to these guidelines are typically rejected with these reason codes:
A7:255 (age/diagnosis mismatch)
A7:86 (gender/diagnosis mismatch)
Following the guidelines above should eliminate these rejections.
Payers affected are:
CPID 4509 CIGNA Health Plans
CPID 6405 CIGNA Health Plans
CPID 5943 CIGNA Behavioral Health
CPID 1841 CIGNA Behavioral Health
CPID 4516 CIGNA Select (Formerly Great West Healthcare)
CPID 6408 CIGNA Select (Formerly Great West Healthcare)
Action Required: Please adhere to the new rules for submitting newborn claims to CIGNA.
If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
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