All PlansDocumentationMedium impact
Ambulatory medical record reviews
Cigna·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 18, 2026
Summary
Cigna Healthcare conducts annual random audits of network providers' ambulatory medical records to validate documentation requirements. The policy outlines a 13-point checklist for medical record reviews, with allergies/adverse reactions, alcohol/tobacco screenings, and advance directive discussions being the most frequently missing documentation.
Action Required
By July 1, 2025: All providers must ensure medical records include complete documentation per Cigna's 13-point checklist. Priority focus on documenting: (1) medication allergies and adverse reactions, (2) alcohol and tobacco usage screenings, and (3) advance directive discussions. Update EMR templates to include these frequently missing elements. Incomplete documentation may result in audit findings and potential compliance issues.