EDI 837 And EDI 999, 277CA Transactions (Cigna)

EDI 837 And EDI 999, 277CA Transactions Guides (Part 3)

EDI 837 And EDI 999, 277CA Transactions are among other EDI transactions supported by Cigna. Cigna is currently using EDI 837 And EDI 999, 277CA Transactions in support of 5010 compliance and is committed to helping physicians and hospitals successfully use and implement EDI 837 And EDI 999, 277CA Transactions. As a result of using EDI 837 And EDI 999, 277CA Transactions, health care professionals and customers will benefit from even quicker and more accurate document processing.

Below in the blog we present the other portion of the Frequently Asked Questions about implementation of the EDI 837 And EDI 999, 277CA Transactions by Cigna and its partners.

• What does a claim status of A3/21 mean?

This is a claim rejection for missing or invalid information that prevented Cigna from being able to accept or process the claim.

1. A3 – Acknowledgement/returned as unprocessable claim. The claim/encounter has been rejected and has not been entered into the adjudication system
2. 21 – Missing or invalid information
3. In most instances, Cigna will provide an additional status code identifying the missing or invalid information.
4. If an additional status code is not provided, the claim was rejected for a workgroup for electronic data interchange (WEDI) strategic national implementation process (SNIP) Level 1 or 2 error. An additional error is not identified because an equivalent claim status code is not available for the error. Please work with your trading partner to review the error on the 999 Acknowledgment.
   • Level 1 – compliance checks for valid segments, segment order, element attributes, verifying that numeric data elements have a numeric value, validation of X12 syntax and compliance with X12 rules
   • Level 2 – compliance checks for HIPAA implementation guide specific requirements like  repeat counts, used vs. unused codes, elements and segments, and required or intra-segment
     situational data elements.

• How should newborn 837 be filed?

Subscriber information should be submitted with the following:

1. The policyholder’s Cigna ID number without the suffix (for example, U1234567801 should be submitted as U12345678)
2. The policyholder’s first name
3. The policyholder’s date of birth
4. Patient information should be submitted with the following:
   • The first name or “Newborn”, “Baby Boy”, “Baby Girl”, or “Twin A”, etc.
   • The newborn’s date of birth.

• What payer ID should be used when submitting claims to Cigna?
  • For medical and dental customers, use the payer ID on the patient’s ID card. If the ID card does not contain a payer ID, use 62308.
  • For behavioral HMO claims use SX071; for behavioral PPO claims use 62308.
  • For Arizona Medicare Advantage claims use payer ID 86033.
  • Cigna will proceed with moving to a single payer ID in the second quarter of 2012.

• How should I submit a rendering address on dental claims (837D)?

The dental claim has a new “Service Facility Address” field that must be used to submit the address where services were rendered.