837 Claim

837 Claim and Claim Acknowledgments (999 and 277CA) Notes (Part 1)

837 Claim and Claim Acknowledgments are among other EDI transactions supported by Cigna. Cigna is currently using 837 Claim and Claim Acknowledgments transactions in support of 5010 compliance and is committed to helping physicians and hospitals successfully use and implement 837 Claim and Claim Acknowledgments. As a result of using 837 Claim and Claim Acknowledgments, health care professionals and customers will benefit from even quicker and more accurate document processing.

Below in the blog we present the first portion of the Frequently Asked Questions about implementation of the 837 Claim and Claim Acknowledgments by Cigna and its partners.

  • Who should I contact to determine what has changed and which fields are required on an 837 claim submission?

Cigna provided all trading partners with the technical guides (companion guides). You should work with your trading partner to determine what has changed.

  • Will Cigna accept a PO Box in the “Billing Provider” field for 5010?

No. With the 5010 changes, a PO Box can be submitted in the “Pay to Provider” field only. You must submit a street address in the “Billing Provider” field. In order to avoid claim rejection and delays, submit any demographic or billing ID (TIN or NPI) changes following standard processes.

  • Will Cigna utilize 999 and 277CA transactions?

Yes, Cigna will utilize the 999 and 277CA with any trading partner that can accept them.

  • Will Cigna be supporting a 277X213 [277 request for additional information (RFAI)]?

Cigna will implement the 277RFAI in 2012 to any trading partner that can accept them. Additional communications will announce when this transaction becomes available.

  • Will Cigna support unique member IDs for dependents?

Yes. Cigna has unique IDs for dependents.

  • Will Cigna provide a TA1 – Interchange Acknowledgment?

Yes, Cigna will provide this information when a TA1 is requested on the submission.

  • Can the service location still be submitted in the “Service Facility” field under 5010?

Yes, if it is different than the “Billing Provider”. The “Service Facility” NPI should only be submitted if the service facility is not a subpart of the organization.

  • Will Cigna audit my current address and contract files?

No. You should review and update your “Billing Provider” and “Pay to Provider” name and address information as needed to avoid claim rejections, delays, or processing errors, especially if you have changed how you submit claims.

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