HIPAA 837

HIPAA 837 And EDI 999, 277CA Transactions FAQs For Cigna Partners

HIPAA 837 And EDI 999, 277CA Transactions refer to the most used EDI transactions in health care and insurance industries. As Cigna is committed to 5010 HIPAA complience, the company is interested in helping physicians and hospitals successfully use HIPAA 837 And EDI 999, 277CA Transactions. Today we give more information (in the form of the Frequently Asked Questions) as for health care 837 And EDI 999, 277CA EDI Transactions.

  • Will paper claims be affected by the 5010 changes?

Yes. Claims sent to Cigna’s mail room are scanned and become electronic claims. Cigna’s mail room will be migrating to Cigna’s new 5010 gateway and will follow the same process as electronic claims. The actual timing for the mail room migration is under review.

  • Is there a limit to the number of lines that can be submitted on a claim?

Yes. Claims with more than 700 claim lines should be split into more than one claim.

  • What date of service should be submitted on a dental predetermination claim?

A date of service should not be submitted on a predetermination claim. If a date of service is submitted at the claim level, it will not be considered a predetermination claim.

  • Will Cigna reject claims if the billing or service facility ZIP code contains all 0’s for the last four digits?

No. Cigna will send a warning on the 277CA that the ZIP code received is not a valid ZIP code, but will not reject the claim.

  • Will Cigna require the license number be submitted on the dental claim?

No. The national provider identifier (NPI) and the billing provider tax ID are required. If you would like to continue to send your license number, Cigna will not reject the claim.

Read more about HIPAA Complience

Learn about succesful EDI and HIPAA implementation scenarios at EDI Academy trainings

Leave a Reply

Your email address will not be published.

Post Navigation