KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
2019 TN HFMA Kelly Miller Payer Summits
WORKING WITH CIGNA
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
AGENDA
2Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
• Introductions
• Provider Digital Solutions
• Claims 101
• Appeals 101
• Keeping you updated
• Resources
• Q&A
Cigna offers a variety of delivery system engagement models that will help providers move
toward a greater value orientation, which is our primary focus.
Open Access Plus LocalPlus®
networks, Cigna
Care Network,
Connect Network,
Cigna SureFit®
Cigna
Collaborative
Care
Ex
am
ple
s IPA*, physician
organized delivery
(POD)
TRADITIONAL
NETWORK
PARTNER
• Fee for service
• Traditional
contracting
relationship
ENHANCED
NETWORK
PARTNER
• Expanded fee for
service
• Flexible network
solutions with
focus on quality
CLINICAL
COLLABORATOR
• Quality bonus and
cost targets
• Embedded care
resources for
coordination
• Data aggregation
and exchange
DELIVERY
SYSTEM
ORGANIZER
• Organizes
independent
providers to
improve health
• Shared risk
• Management
services
Degree of collaboration and provider risk
Low High
engagementour delivery system
models
3Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
* Independent practice association
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
Tools to make your life easier
PROVIDER DIGITAL SOLUTIONS
4Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
Provider type
A “provider type” field has
been added. This added
field helps you distinguish
between a physician group
and a facility that share the
same name.
Provider record view
Easily view all records
(names or NPI* numbers)
by TIN**, and their EFT
status in an expanded
table format
Enhancements to Enroll in EFT Options screen
5Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Effective November 2017
Auto-select records
A record that is not enrolled
will be automatically
selected for enrollment.
You have the ability to
uncheck records you do
not wish to enroll.
*National Provider Identifier
**Taxpayer Identification Number
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
6Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Enroll in EFT
Options
Fully enroll in EFT
quickly and easily.
Effective November 2017
Enhancements to Enroll in EFT Options screen
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
7Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
HRA, HSA, and FSA*
information and plan
renewal indicator
Quickly see when your
patient’s plan renews and if
your patient has one of
these health accounts.
Patient and Plan Detail tab enhancements – plan renewal indicator
and health account status
Effective November 2017 & April 2018
*Health reimbursement account, health savings account, and flexible spending account
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
8Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Am I in-network for
this patient?
Click a link to quickly view
the plans and networks you
participate in and see if you
are in network for this
patient.
Effective February 2018, updated July 2018
Am I in-network for this patient?
Patient and Plan Detail tab enhancements – network status
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
9Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Link to provider
directory
Need to search for an in-
network specialist or facility
when referring a patient?
Now you can link to the
provider directory from the
patient screens.
Notification, Referral, and Precertification Requirements tab
enhancements – provider directory links
Effective March 2018
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
10Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Referral Required
The Referral Required
indicator is now available
for SureFit and non-SureFit
patients.
Effective March 2018
Notification, Referral, and Precertification Requirements tab
enhancements – Referral Required indicator
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
11Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Frequency and
utilization data
For certain patient benefits,
you will be able to see the
number of visits used and
the number remaining.
Effective May 2018
Frequency and utilization data
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
12Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Pended claim attachments
• Electronically submit
supporting documentation
for pended claims
• Pend reason codes
clearly explain what
additional information is
needed.
Claim Details screen enhancements
When you use this feature, we’ll be able to process your pended claims more quickly.
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
Pended claim attachments details
13Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
About attachments
You can:
• Send up to six files at a time,
for a total file size of 35 MB.
(The maximum size for an
individual file is 10 MB.)
• Submit files in any of these
formats: BMP, GIF, JPEG, PDF,
PNG, or TIF.
• Easily convert a Microsoft file
into a PDF. Note that PDF files
cannot be more than 998
pages.
• Name files with a maximum of
128 characters, including the
file extension.
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
14Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
LocalPlus and SureFit web and EDI* enhancements
Effective November 2017
Cigna Cost of Care
Estimator®
You can now use the
estimator for patients with
Cigna LocalPlus and Cigna
SureFit coverage.
ERA (835)
You will be informed if the
claim was adjudicated as a
Cigna SureFit benefit.
SureFit provider
directory
From the patient screens,
you will be able to access a
patient-specific SureFit
directory from the Useful
Links and the Notifications,
Referrals & Pre-Cert
category.
Effective November 2017
*Electronic data interchange
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
15Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
PCP* Panel Reports
You will have the ability to
pull a PCP Panel Report
for your designated SureFit
patients.
Patient Coverage Details screen enhancements
Effective November 2017
*Primary care provider
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
16Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
if coverage details indicate
that outpatient services
require precertification:
Click View Medical
Precertification Information.
This will bring you to the
Precertification Policies
page.
Does this outpatient service require precertification?
Cigna for Health Care Professionals website
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
17Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
From the Resources tab,
you can also find:
• General precertification
information. Click
Precertification.
• The Master Outpatient
Precertification List. Click
Reimbursement and
Payment Policies >
Precertification Policies >
Master Outpatient
Precertification List.
General precertification information and the Master Outpatient Precertification List
Cigna for Health Care Professionals website
KEY TRENDS IMPACTING THE HEALTH CARE DELIVERY SYSTEM
Cigna for Health Care Professionals website
18Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Click Master Outpatient
Precertification List
This is a searchable, detailed
listing of procedures and
corresponding codes for
services that require
precertification.
To search for a procedure
code, click Ctrl + F.
Master Outpatient Precertification List
19Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
ELECTRONIC TRANSACTION SAVINGS OPPORTUNITIES
TransactionEstimated per transaction:
Provider cost Potential savings
Claim submissionManual $2.37
$0.92Electronic $1.45
Eligibility and
benefit verification
Manual $3.61$2.60
Electronic $1.01
Prior authorizationManual $6.61
$3.81Electronic $2.80
Claim status
inquiry
Manual $7.12$5.23
Electronic $1.89
Claim payment*Manual $2.11
$0.24Electronic $1.87
Remittance
reports
Manual $2.99$1.84
Electronic $1.15
Source: CAQH, 2018 Index
Significant savings are available to providers who choose electronic over manual transactions
*Electronic funds transfer (EFT) is the required method for providers to receive reimbursements.
Tips to make the claims filing and resolution process easier
CLAIMS 101
20Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
CLAIM DENIAL REASONS
21Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Frequent claim denial reasons:
– Duplicate claim submissions
– claim already in process
– claim previously processed
– Missing information
– Medicare explanation of benefit (EOB)
– Other insurance EOB
– Revenue codes itemization
Carefully review the message(s) on your Explanation of Payment (EOP) to determine the
reason for a denial of services or a payment reduction. If you have questions about a
denial, please call the Cigna Customer Service toll-free number on the patient’s ID card.
Avoid potential claim payment delays.
DUPLICATE CLAIM DENIALS
22Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
• Use the Claim Frequency Type Code in loop 2300, segment CLM05, to
specify the frequency of the claim. (This is the third position of the UB04
bill type.)
• Use one of the following codes to indicate the claim type:
• 1 – Original (admit through discharge claim)
• 7 – Replacement (of a prior claim), include Payer Claim Control # in
segment REF*F8
• 9 – Void (or cancellation of prior claim), include Payer Claim Control
# in segment REF*F8
When a corrected claim is submitted, you will receive a “duplicate to claim
already in process” denial message and the corrections will be applied to the
original claim.
Submit corrected claims electronically.
MEDICARE AND OTHER INSURANCE
23Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
• Both primary and secondary (COB) claims can be submitted to us electronically.
• You don’t have to submit Medicare Part A and Part B coordination of benefits
agreement (COBA) claims to us, as the Medicare EOB or ERA will show that those
claims have been forwarded to us as the secondary payer.
• Talk to your EDI vendor about COB information.
• It should be billed in loops 2320 and 2330 in the electronic claim form. Values in those
loops must balance with loop 2300 Monetary Amount reported.
Submit COB (coordination of benefits) claims electronically.
REQUESTS FOR ADDITIONAL INFORMATION
24Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Cigna routinely evaluates claims for coding, billing accuracy, and appropriateness and
may request supporting claim payment information such as:
– An itemized bill
– Medical records
Once the claims review is completed, we will:
– process and reimburse the claim accordingly
– issue an explanation of payment
– send you a letter explaining any charges determined to be not payable
Visit the secure Cigna for Health Care Professionals website for a list of the Not-Payable
Reason Codes, including descriptions and reconsideration criteria, at CignaforHCP.com >
Resources > Reimbursement and Payment Policies > Clinical Claim Review Not Payable
Reason Codes.
Respond to requests for information timely.
CLAIM SUBMISSION TIPS
25Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
• Include the Present On Admission (POA) indicator for all diagnosis codes submitted on
the inpatient claim form. Refer to the Hospital Acquired Conditions Reimbursement
Policy located on the secure Cigna for Health Care Professional website at
CignaforHCP.com > Resources > Clinical Reimbursement Policies and Payment
Policies > Modifiers and Reimbursement Policies for more information.
• Submit newborn claims with the following information:
– the subscriber’s Cigna ID number without the suffix
– the subscriber’s first and last names (not the mother, unless she is the subscriber)
– the patient’s first name and last name, or Newborn, Baby Boy, Baby Girl, Twin A,
Twin B, etc.)
– the patient’s date of birth
– the patient’s gender
Refer to these additional claim submission tips.
PAYER SOLUTIONS: THIRD-PARTY ADMINISTRATORS
26Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Cigna contracts with third-party administrators (TPAs), selected insurers, and claim administrators
(referred to collectively as “payers”) to share the administration of self-funded Administrative Services
Only (ASO) plans. We also contract with several insurance companies that issue individual and group
insurance policies.
For these relationships, we:
• provide access to our network
• perform medical management and utilization reviews
• re-price claims according to our contracted rates and claims logic
• provide clinical appeals management
• provide contract dispute resolution
TPAs and insurance companies:
• maintain eligibility
• administer benefits
• pay claims for these shared accounts on their own systems
Understand the Payer Solutions we offer.
PAYER SOLUTIONS: POINTS OF INTERACTION
27Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Claim flow:
• Claims should be submitted to Cigna (payer ID 62308
or to the claims mailing address on the patient’s ID card
• Cigna prices the claims based on the network
contracted rates
• The priced claim is then forwarded to the payer
for payment based on the patient’s eligibility
and benefits
• The payers then remit payment following
contractually agreed upon turnaround requirements
Clinical and contract-related appeals:
• Appeals of clinical denials should be sent to Cigna
using the contact information supplied in the
denial letter(s)
• Appeals of application of contract rates should go to
the address on the patient’s ID card
Contact the payer* for:
• Eligibility
• Benefits
• Precertification
• Claims status
• Non-pricing appeals
* The contact phone number is
located on the patient’s
ID card
Contact Cigna* for:
• Reimbursement issues
• Pricing appeals
• General contract
questions
* The contact phone number for
Cigna is 1.888.663.8081
CLEAR CLAIM CONNECTION™
28Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Click “I ACCEPT.”
On CignaforHCP.com:
1. Hover over claims
2. Click on View Claim Coding Edits
3. Window will come up with Agreement
4. Click I ACCEPT
5. Sample screen will appear to enter patient
information (see below):
CLEAR CLAIM CONNECTION (CON’T)
29Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Sample screen will come up where you can enter customer’s information.
Click “Review Claim Audit Results.”
CLEAR CLAIM CONNECTION (CON’T)
30Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Note that one claim will be accepted, and one claim will not. To determine why the claim will
not be accepted, click “Disallow.”
The next screen provides a detailed explanation.
Tips for filing an appeal
APPEALS 101
31Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Cigna strives to informally resolve issues raised by providers on initial
contact whenever possible. If issues cannot be resolved informally:
– Cigna offers a single-level, internal appeal process to resolve contractual
disputes regarding post-service payment denials and payment disputes. Processes
may vary due to state mandates or contract provisions.
– The appeal must be initiated within 180 calendar days of the date of the initial
payment or denial decision.
– Arbitration may be used as a final resolution step after the internal Cigna process is
complete.
32Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Patients with Cigna ID cards
Patients with GWH-Cigna or “G” ID cards
Cigna Appeals Unit PO Box 188011 Chattanooga, TN 37422 Fax: 1.877.815.4827
Cigna Appeals Unit PO Box 188062 Chattanooga, TN 37422 – 8062 Fax: 1.877.804.1679
APPEAL PROCESS
FILING AN APPEAL
33Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
• Most claim issues can be remedied quickly by providing requested information to a
claim service center, contacting us, or resubmitting the claim. Carefully review the
message(s) on your EOP to determine the reason for a denial of services or a
payment reduction.
We recommend contacting Cigna Customer Service before filing an appeal for:
– Claim errors
– Contract and fee disputes
– Out-of-network claim payment disputes
For additional information on how to submit an appeal, please review the Claim
Adjustment & Appeals Guidelines on CignaforHCP.com > Resources > Clinical
Reimbursement Policies and Payment Policies > Claims Appeals Policies and
Procedures > Appeal Policy and Procedures.
Understand the denial before you file an appeal.
34
This review provides an
opportunity to provide additional
clinical information.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Request a peer-to-peer review
before filing an appeal. It may
result in a reversal of a previous
coverage decision.
If the peer-to-peer review does not
result in a revised coverage
decision, you may still submit an
appeal through our appeal process.
Initiate by
calling:
1.800.88Cigna
(882.4462),
option 3
Peer-to-peer process
NATIONAL ANCILLARIES
35Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
36Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
National Ancillary Programs*providing your patients with
quality and
cost-effective
care
20% decrease in
unnecessary
radiology
procedures1
45%–80% savings with national labs over other lab services2
45%–50%
savings on total
chiropractic costs4
Up to $50,000 per
case savings using
in-network outpatient
dialysis facilty3
Accessible
Quality focused
Cost efficient
Patient oriented
Service National ancillary providers*
Chiropractic American Specialty Health®
Dialysis• Davita
• Fresenius
Durable medical equipment, home
health care, infusion therapyCareCentrix
Hearing Amplifon Hearing Health Care
High-technology radiology and
diagnostic cardiologyeviCore healthcare
Integrated Oncology Management
ProgrameviCore healthcare
Laboratory**• LabCorp®
• Quest Diagnostics®
Musculoskeletal and pain management eviCore healthcare
Orthotics and prosthetics Linkia
Physical and occupational therapy American Specialty Health®
Radiation therapy eviCore healthcare
Sleep management services CareCentrix
Vision services Vision Services Plan*List is not all-inclusive of every national ancillary provider. Ancillary providers do
not manage services in all states and markets.
**We currently contract with numerous local and national laboratories, including LabCorp® and Quest
Diagnostics, Inc. and other reference, pathology, genetic, and esoteric labs, to provide quality laboratory
services at in-network, cost-effective rates.
The latest information on policy and coverage updates.
KEEPING YOU UPDATED
37Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
RECENT COVERAGE POLICY AND PRECERTIFICATION UPDATES
38Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna 38
Policy and coverage updates April 2019
• Peripheral angioplasty
—Percutaneous Revascularization of the Lower
Extremities in Adults (0537)
March 2019
• Perfusionist services
—Facility Routine Services, Supplies and Equipment
Reimbursement Policy (R12)
• Ashkenazi Jewish laboratory panel
—Genetic Testing Panels (R28)
—Genetic Testing for Reproductive Carrier
Screening and Prenatal Diagnosis (0514)
February 2019
—Diagnostic Microbe Testing for Sexually Transmitted
Diseases (0530)
—National Correct Coding Initiatives for Facilities
Reimbursement Policy (R09)
January 2019
—Cardiac Electrophysiological Studies (0532)
Information about these updates and others is available on the
Cigna for Health Care Professionals website
(CignaforHCP.com).
Precertification changes
Codes added to the precertification list on January 1, 2019
We added 27 new Current Procedural Terminology (CPT®) codes.
• 0045U through 0061U
• 0505T through 0508T
• 22551 and 22554
• 22600
• 93653
• 93656 and 93657
We added seven Centers for Medicare & Medicaid Services (CMS)
Healthcare Common Procedure Coding System (HCPCS) codes.
• C9030
• C9301
• C9032
• Q5105
• Q5106
• Q9993
• Q9995
Codes to be removed from the precertification list on
March 17, 2019
• 81287
• 81324
• 81412
A complete list of precertification changes is available on the Cigna for Health
Care Professionals website (CignaforHCP.com).
DEMOGRAPHIC CHANGES
39Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
Please notify us in writing 90 days before changing your office or billing address, telephone number, Taxpayer Identification Number (TIN), National Provider Identifier (NPI), or specialty. You can submit your demographic changes by email, fax, mail, or online. Refer to the chart below to identify the contact information for your state.*
How you can submit changes
Email: [email protected]
Fax: 1.877.358.4301
Mail: Cigna
Provider Data Management
Two College Park Drive
Hooksett, NH 03106
Online: Cigna for Health Care
Professionals website (CignaforHCP.com
> Resources > Forms)
New requests and existing contract
inquiries
Email: [email protected]
Fax: 1.866.509.4544
Credentialing status inquiries
Telephone: 1.800.88Cigna (882.4462) select
the options for credentialing
Email: [email protected]
Email: [email protected] to be added to the distribution.
40Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
resourcesfor you
• Quarterly Network News
• Use material in meeting packet
• Go to the Cigna for Health Care
Professionals website (CignaforHCP.com)
41Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
CONTACTS AND SUPPORT
your
resourcesyour
way
• Webinars
(CignaforHCP.com > News You Can Use)
• General eServices product information
(CignaforHCP.com > Resources > Doing
Business with Cigna > eServices)
• eCourses
(CignaforHCP.com > Resources > Doing
Business with Cigna > eServices )
• EFT payment calendars
(CignaforHCP.com > Resources > Doing
Business with Cigna > eServices )
• Your EDI vendor
Don’t have an EDI vendor?
Visit Cigna.com/EDIvendors
for more information
• 1.800.88Cigna
• Your Experience Manager or
Experience Consultant
QUESTIONS?
42Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
43Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2019 Cigna
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company,
Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo,
and other Cigna marks are owned by Cigna Intellectual Property, Inc.
THN-2019-174-TN 03/19 © 2019 Cigna. Some content provided under license.