Cigna SureFit Quick Reference Guide

 

tracelogoRB Reference Guide for Cigna SureFit

 

This section applies only to HNS providers practicing in North Carolina.

 

The Cigna SureFit Quick Reference Guide provides information specific to the Cigna SureFit plan concerning Cigna SureFit claims, Cigna SureFit members, and Cigna SureFit policies. The information in this section is in addition to the HNS/Payor Policies.  The Cigna SureFit Quick Reference Guide contains the following information specific to Cigna SureFit and provides you with helpful information regarding your Cigna SureFit claims.

 

General Information

 

Provider Directory

 

Eligibility/Benefits

 

Referral from PCP Required

 

Subscriber ID Cards

 

Claims Submission

 

Claims Inquiries

 

Provider Relations

 



General Information

 

Cigna SureFit is a new plan offering that builds networks around local physician and hospital groups and provides our customers with access to personal, patient-centered care.  In Raleigh, UNC Health Care is the major participating health system.

               

Please do not send claims directly to Cigna SureFit.  All Cigna SureFit claims must be sent to HNS. Please ignore the claims billing address on the member ID card or any address given to you on the telephone when verifying eligibility and benefits. You are under contract as a participating Cigna SureFit provider through HNS and our instructions for filing claims supersede information given to you by Cigna SureFit Representatives.

  

If you have any questions concerning Cigna SureFit, please contact your HNS Service Representative. Your HNS Service Representative's email address is displayed on the provider dashboard on the secure section of the HNS website.

 

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Provider Directory

 

All HNS providers in North Carolina are participating providers with Cigna SureFit, but only those providers who practice in the following counties (where this product is currently offered) will have their names appear in the provider directory.

  • Chatham
  • Johnson
  • Nash
  • Orange
  • Wake

 

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Eligibility/Benefits

 

Be sure to verify eligibility for each Cigna SureFit member.

  

Please remember to ask for specific information on chiropractic benefits for each member. CLICK HERE to see a sample Verification of Eligibility/Benefit Form.  

  

To verify eligibility and benefits - Refer to the telephone number on the member's identification card.

  

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Referral from PCP Required

 

Because this plan is an HMO, referral from PCP is required for all chiropractic (and any other specialist) visits. However, NO referral info is required to be included on the claim form. Instead, the patient's health care record must include evidence of the PCP referral.

 

Chiropractors can confirm referrals by using one of the following options:

  • The PCP's written referral presented by the patient.
  • Calling Cigna Customer Service at 1.866.494.2111 and choose the prompt for specialist referral.

 

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Subscriber ID Cards

 

Subscriber ID cards may or may not display the Cigna standard name/logo, but will clearly state Cigna SureFit and display the UNC HEALTH ALLIANCE/UNC HEALTH CARE name/logo.

  

As with almost all HMO products, there is NO out-of-network benefit.  This product was built for the UNC Health Care system.

 


 

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Claims Submission

 

 All claims for Cigna SureFit patients should be submitted electronically to HNS.

   

Please ignore any instructions regarding where to submit claims by payor phone representatives. HNS instructions regarding where to submit claims supersede all other instructions given by payor representatives when verifying eligibility and benefits.

 

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Claims Inquiries

 

For tracing outstanding claims (after 60 days from your billing date), please email you HNS Service Representative and include the patient name, date of birth, member ID number and the dates of services in question. We will gladly trace the claim for you and will respond back to you within three business days.

  

Resubmit lost/missing claims through HNS.

  

Refer to your HNS/Cigna fee schedule to confirm allowable amounts if prior authorization was obtained before rendering services.

 

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Provider Relations 

 

Questions relating to your participation in Cigna SureFit should be directed to your HNS Service Representative. Your HNS Service Representative's email address is displayed on the provider dashboard on the secure section of the HNS website.

  

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