cigna 270 and 271

Cigna 270 and 271 Eligibility and Benefits HIPAA Transactions: Questions And Answers

Cigna 270 and 271 Eligibility and Benefits Transactions provide access to Medicare Beneficiary eligibility data in a real-time environment. Providers, clearinghouses, and/or third party vendors may initiate a real-time 270 eligibility request to query coverage information from medicare on patients for whom services are scheduled or have already been delivered. In real-time mode, the trading partner transmits a 270 request and remains connected while the receiver processes the transaction and returns a 271 response. The data included in a Cigna 270 and 271 Eligibility and Benefits Transactions file is to be considered true and accurate only at the particular time of the transaction. Typical questions and answers regarding Cigna 270 and 271 Eligibility and Benefits Transactions are provided below.

Who can I contact to determine what is changing and which fields are required on a 270/271 benefits and eligibility submission?

Cigna will require the fields mandated by the 5010 Technical Report (TR3). Cigna has provided all trading partners with the technical guides (companion guides). You should work with your trading partner to determine what is changing.

Is Cigna currently able to accept and send 270/271 eligibility transactions?

Yes. Cigna currently conducts the 270/271 eligibility, coverage and benefit inquiry transaction with many trading partners. Cigna is CORE Phase I certified.

What kind of information does Cigna have available for the 270/271 eligibility transactions?

For details on the type of information Cigna returns on the 271, please access the eCourse on the Cigna for Health Care Professionals website (CignaforHCP.com > Education and Help > EDI Eligibility and Benefits.

Will Cigna support 270 alternate name searches detailed in the TR3?

Yes. Cigna will support the alternate member search options. If Cigna is unable to make a unique match based on the search options entered, an AAA segment will be returned to request additional search criteria.

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.

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