Are you a healthcare provider looking to start accepting Cigna-insured patients? To do that, you need to get credentialed with Cigna first.
But here’s the challenge: the credentialing process can feel complicated and time-consuming. From filling out forms to gathering the right documents, it can seem like a lot of work.
However, in this blog, we’ll walk you through the step-by-step process to get credentialed with Cigna. We’ll cover everything you need to join the Cigna network and start accepting insured patients with ease.
What Is Cigna Provider Credentialing?
Cigna provider credentialing is the process that healthcare providers go through to be approved and added to Cigna’s network. It means that you, as a provider, are recognized and authorized by Cigna to offer medical services to Cigna-insured patients and get paid for those services.
Being credentialed with Cigna is essential for several reasons:
- Access to More Patients: Once you’re credentialed, you’ll be able to accept Cigna-insured patients, expanding your patient base.
- Payment for Services: Only credentialed providers can submit claims and receive reimbursement for the care you provide.
- Increased Credibility: Being part of the network boosts your practice’s credibility, showing patients that you’re a trusted healthcare provider recognized by a major insurer.
Without credentialing, you’re unable to offer services to Cigna-insured patients, which means lost opportunities and revenue for your practice. It’s a critical step for growing your business and reaching more people who need your care.
Who Needs to Be Credentialed with Cigna?
a list of healthcare providers who must go through the credentialing process with Cigna:
- Physicians (MDs, DOs)
- Mental Health Providers (Psychologists, Psychiatrists, Therapists)
- Dentists & Orthodontists
- Dietitians & Nutritionists
- Chiropractors
- Podiatrists
- Physical Therapists & Occupational Therapists
- Other Healthcare Providers (e.g., Nurse Practitioners, Physician Assistants, etc.)
If you’re providing healthcare services and want to work with Cigna-insured patients, you’ll need to be credentialed with them. This applies whether you’re an individual provider or part of a practice group.
Documents Required for Cigna Credentialing
To complete your Cigna credentialing application, it’s important to submit the right documentation. These documents help Cigna verify your qualifications and ensure you’re ready to join their network of providers. Below is the list of required documents, with a special focus on Behavioral Health Credentialing requirements.
Cigna Behavioral Health, Inc. has officially transitioned to “Evernorth Behavioral Health, Inc.” As part of this transition, the following credentialing requirements must be met for individual providers to join the network:
- License to Practice Independently
- You must be licensed to practice independently in the state where you are providing services.
- Professional Liability Insurance
- $1 million/$3 million for Physicians and Psychiatric Nurses with prescriptive authority, or
- $1 million/$1 million for all other providers.
- Exceptions based on state requirements:
- Texas: Minimum liability coverage of $200,000 per occurrence and $500,000 aggregate.
- Florida: Minimum liability coverage of $100,000 per occurrence and $300,000 aggregate.
- If you have federal tort coverage (Federal Tort Coverage Act), you do not need to meet Evernorth’s insurance requirements. Include a federal tort letter or attestation if applicable.
- National Provider Identifier (NPI)
- You must have a valid NPI number to proceed with the credentialing application.
- CAQH Profile
- Documents required for it
- W-9 form for the Taxpayer Identification Number (TIN) you are using.
- State license for all locations where you will be providing services. Ensure the expiration date is at least 60 days away.
- DEA registration (for prescribing providers only). Make sure the expiration date is at least 60 days away.
- Highest level of education.
- Professional liability insurance (expiration date must be at least 60 days away).
- Five years of consecutive work history with no gaps of more than six months, or substitute with education history.
- Evernorth Behavioral Health Provider Information Form must be completed after application submission. To join the Cigna network as a provider, complete the Evernorth Behavioral Health Provider Information Form. Download the PDF and then submit it to their email: BehavioralOutpatientClinic@Evernorth.com
- Documents required for it
- Review & Next Steps
After you submit your application, Evernorth Behavioral Health will review it and reach out to you within 21 business days (or as required by law) with next steps regarding credentialing and contracting.
Step by Step Process to Get Credentialed with Cigna Health Insurance
Getting credentialed with Cigna might feel like a long process, but breaking it down into manageable steps can make it easier. Here’s a clear step-by-step process to help you through the credentialing and enrollment process:
Step 1: Get Your NPI
Before starting the credentialing process with Cigna, you’ll need your National Provider Identifier (NPI). This unique 10-digit number is required for all healthcare providers, and it’s crucial for creating your CAQH profile and completing your application.
- Already have your NPI? Great! You’re one step ahead. Head over to your CAQH profile and update your details.
- Don’t have an NPI yet? No worries, you can easily apply for one by clicking here to get your NPI. Once you have your NPI, you’ll be able to proceed with creating your CAQH profile and start your Cigna credentialing process.
Step 2: Complete Your CAQH Profile
Having a complete and up-to-date CAQH profile is essential for your Cigna credentialing process, as Cigna relies on the data in your CAQH profile to verify your qualifications.
Here’s what you need to do:
- Log In to CAQH ProView:
- New to CAQH? Click here to register and create your profile.
- Already have a profile? Log in to make sure everything is up-to-date.
- Ensure all necessary documents are uploaded to your profile. This typically includes:
- Double-check that all information is accurate and complete. This includes your personal details, professional history, and any other required information like work history, NPI, and practice information.
- Once your CAQH profile is up-to-date, grant Cigna access to view your profile by clicking the necessary consent option in CAQH. This allows them to directly pull your information for verification.
- Attest to your information every 120 days (or 180 days for Illinois providers)
Tip: If your profile isn’t complete or up-to-date, Cigna won’t be able to verify your credentials, and this could delay the entire credentialing process. With a complete CAQH profile, you’re one step closer to getting credentialed with Cigna and starting to accept their insured patients!
Step 3: Visit the Cigna Provider Portal
Once your CAQH profile is ready, visit the Cigna Provider Portal to start your credentialing application.
- Go to the official Cigna Provider Portal and create an account or log in.
Step 4: Fill Out Your Provider Application
Now that you’re in the Cigna system, fill out your provider application. This includes entering important details such as:
- Provider Type (Physician, Mental Health Provider, Dentist, etc.)
- Tax ID Number (TIN)
- National Provider Identifier (NPI)
- Practice Information (address, phone number, etc.)
Step 5: Wait for Cigna’s Verification
Once your application and documents are submitted, Cigna will review your information. This process typically takes 90 days, though it can vary depending on the volume of applications and the complexity of your credentials.
Step 6: Final Approval and Enrollment
After everything is reviewed and verified, you will receive credentialing approval from Cigna. You’ll then be officially enrolled in their network and ready to accept Cigna-insured patients.
How Long Does Cigna Credentialing Take?
Credentialing with Cigna typically takes 90 days from the time they receive your complete application and all required documents. However, there are a few factors that can either speed up or delay the process.
- Incomplete or Missing Documents: If any required documents are missing (such as expired licenses, missing malpractice insurance, or incomplete W-9 forms), your application may be delayed or rejected.
- Incorrect or Inconsistent Information: Mismatched information (like incorrect NPI or address discrepancies) can cause Cigna to return your application for corrections, delaying approval.
- High Volume of Applications: At certain times, especially during open enrollment periods, Cigna may receive a large number of applications, which can cause longer processing times.
- State-Specific Requirements: Different states may have unique credentialing requirements, and if these aren’t met, it can cause delays.
- Failure to Update CAQH Profile: If your CAQH profile isn’t updated or re-attested, it may result in delays. Cigna uses CAQH to verify your credentials, and an outdated profile can halt the process.
How MantraComply Can Help You
The credentialing process with Cigna can be complicated, and managing it on your own might lead to delays, missing documents, or even rejections. But MantraComply is here to make the process smoother and faster, ensuring that you’re credentialed and ready to accept Cigna-insured patients without the usual hassle.
Here’s how MantraComply can help:
- Complete & Accurate Applications: Ensure all documents are submitted correctly the first time.
- Document Tracking: Keep all credentialing documents in one place, easily accessible and up-to-date.
- Real-Time Progress: Track your application status and know exactly where you stand.
- Deadline Reminders: Receive automatic reminders for re-attestation and document renewals.
- Expert Support: Let our team handle the follow-ups and updates for you.
With MantraComply, you can reduce delays, stay organized, and focus on growing your practice.
Ready to Get Credentialed with Cigna Faster?
Don’t let paperwork hold you back. Don’t let paperwork slow you down. MantraComply simplifies the credentialing process by offering:
- Expert support handling follow-ups and renewals for you
- AI-powered automation for error-free applications
- Real-time tracking to follow your application’s progress
- Complete document management in one secure place
- Timely reminders to ensure you never miss a deadline
Start Your Credentialing Process Today and let us handle the rest!
