HIPAA 5010 Compliance At Cigna (Frequently Asked Questions)

HIPAA 5010HIPAA 5010 transactions are currently accepted and sent at Cigna in support of HIPAA 5010 compliance.  Cigna is committed to helping physicians and hospitals successfully use HIPAA 5010 transactions. When the transition to HIPAA 5010 transaction is complete, Cigna expects that health care professionals and customers will benefit from even quicker and more accurate claim processing.

HIPAA 5010 Compliance FAQs

  • What do I need to do to become HIPAA 5010 compliant?

You should work directly with your trading partner to determine what is needed to become 5010 compliant. Trading partners are working with Cigna to ensure all files are 5010 compliant.

  • Why is it important for me to work directly with my trading partner?

Trading partners are upgrading their systems to be able to handle HIPAA 5010 transactions. It is important for you to understand your trading partner’s requirements, because the trading partner may have built compliance checks or other helpful capabilities into their process.

  • Am I required to update my computer software?

Required software updates are based on your software or system. You should contact your trading partner to verify if any updates are needed.

  • Is a national provider identifier (NPI) required to submit 5010 transactions?

Yes. A NPI is required when submitting 5010 transactions.

  • 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.

  • Has Cigna provided 5010 companion guides?

Cigna provided clearinghouses with technical companion guides for each trading partner. Your trading partner should use the information provided in that guide to produce a less technical document for you or your software vendor to use.

The following companion guides were distributed:

  • 837 Institutional – inbound
  • 837 Professional – inbound
  • 837 Dental – inbound
  • 837 Institutional – outbound (Alliance)
  • 837 Professional – outbound (Alliance)
  • 835
  • 834
  • 820
  • 277 RFAI
  • 277 PEND
  • 276/277 Batch and interactive
  • 278 Request/response batch and interactive
  • 270/271 Batch and interactive
  • 837 Institutional – outbound (redirects)
  • 837 Professional – outbound (redirects).

More about HIPAA EDI Complience

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