CommercialAdministrativeMedium impact
Eligibility verification enhancement for patients with plans administered by a third party
Cigna·Coverage
Effective date
Oct 31, 2023
We identified it
Jun 19, 2026
Summary
Cigna Healthcare has enhanced eligibility verification for patients with third-party administrator (TPA) plans, allowing providers to use EDI transactions (ANSI 270/271) through practice management systems. The system now provides TPA contact information when eligibility verification indicates shared administration.
Action Required
Immediately: Front desk and billing staff should begin using EDI eligibility verification (ANSI 270/271) for all Cigna Healthcare patients. Look for 'Shared Administration' or 'S' on patient ID cards to identify TPA plans. Contact the TPA directly (using phone number from 271 response or ID card) for all eligibility, benefits, precertification, and claims inquiries - do not contact Evernorth Behavioral Health for these questions.