Cigna credentialing begins with a phone call, which catches a lot of practices off guard, since most expect to start with an application. Cigna’s instructions have you call first, and the rest of the process follows from what that call tells you.
Here is how the steps run, what to gather, how long to plan for, and where applications tend to get stuck. It works for solo providers and for groups bringing on a new hire.
Key Takeaways
- Call Cigna’s credentialing line first. Cigna tells you on that call whether you meet its basic guidelines.
- You can submit through CAQH, One Healthport/Medversant, or a state application, depending on your state.
- Cigna says credentialing typically takes 45 to 60 days once it has your completed packet.
- Authorize Cigna in CAQH and keep your attestation current, or the file can stall.
- Check status by email to PSSCentral@Cigna.com or by phone, and have your TIN ready.
- Answer recredentialing emails right away, because ignoring them can end your network participation.
How Cigna Credentialing Works
Cigna lays out the medical network process in a short sequence.
- Call 1-800-882-4462 and choose the credentialing option. In most cases you learn on that call whether you meet the basic guidelines to apply.
- If you qualify, Cigna emails you the application packet. Facilities and ancillary providers are asked for more information first, and the representative explains the next steps.
- Send the completed packet through CAQH, One Healthport/Medversant, or a state application that you complete, sign, and mail.
- Cigna verifies the information, then emails you an approval with your effective date.
Cigna’s page does not separate credentialing from contracting for medical providers. It speaks of becoming a network-participating provider once you are approved, so ask your Cigna contact whether a contract step applies to you. If you want a primer on the verification side, read our overview of medical credentialing.
Choosing How to Submit: CAQH, Medversant, or a State Form
Which route you take depends on your state and on what you already have. If you keep a CAQH profile, that is usually the quickest, because the information is already gathered. Authorize Cigna to see it, review the profile for changes, and confirm its status reads either initial profile complete or re-attestation.
If you use One Healthport/Medversant, check that your profile was attested within the last 100 days. Some states require their own application, which you fill out, sign, and mail.
The platform behind CAQH is now the CAQH Provider Data Portal, formerly CAQH ProView, and it sits under DataSpring. Our post on what CAQH is covers the basics, and our CAQH ProView form lets us build the profile for you.
What to Have Ready
Whichever route you use, Cigna wants a complete packet.
- State licenses, plus DEA and CDS certificates where they apply
- Hospital privileges
- Board certification
- Education and training
- Work history, with any gaps explained
- Any sanctions and your malpractice history
- Proof of malpractice insurance
Cigna recommends malpractice coverage of at least $1,000,000 per occurrence and $3,000,000 in the aggregate. The DEA certificate form and the Hospital Coverage Agreement form are faxed, so check Cigna’s page for the current fax number before you send them.
How Long Cigna Credentialing Takes
Cigna says credentialing typically takes 45 to 60 days after it receives your completed packet. The 60 to 90 day figure this guide used before did not come from Cigna, so use Cigna’s number as your starting point.
That clock starts late, though. Getting the packet together, attesting in CAQH, and chasing references all happen before it, and our average credentialing turnaround across payers is about 85 days from start to finish. Once you are approved, Cigna says your information is typically loaded to its directories and claim systems within 10 business days. Do not book Cigna patients until you have your effective date in writing.
Checking Your Cigna Credentialing Status
There are two ways to ask. Email PSSCentral@Cigna.com with your full name and Taxpayer Identification Number, or call 1-800-882-4462 and choose the credentialing option.
Follow up every two to three weeks, and log the date, the person you reached, and what they said. A written trail is the thing you will want if a file goes quiet.
Adding a Provider to an Existing Cigna Group
Cigna’s public page does not describe a separate process for adding a practitioner to a group that already participates. Call the credentialing line and ask what the group needs to send, since the answer can depend on your state and contract.
Expect to submit the new provider’s own CAQH profile or application, along with current licenses and malpractice coverage. Hold off on scheduling Cigna patients with that provider until the effective date arrives.
Common Delays and How to Avoid Them
Most slow Cigna files come down to a handful of causes.
- An incomplete or stale CAQH profile. Set a reminder to update it, and use the completeness meter to catch empty sections.
- Cigna not authorized to view the profile. Confirm authorization before you submit.
- Slow verification. Tell former employers and references to expect a call, and give more than one way to reach each.
- Gaps or unexplained history. Write a short explanation of any gap, disciplinary action, or malpractice claim.
- Network need. Cigna may be thin or full in your area, so describe the services and specialties you add.
Recredentialing with Cigna
Cigna starts recredentialing with an email asking you to verify and re-sign your CAQH information, followed by up to three reminders. Cigna warns that if you do not log in, your participation in its network can be terminated. Treat those emails like a deadline.
Cigna’s page does not state a cycle length. The industry standard comes from NCQA, which requires recredentialing every three years, so plan on that rhythm. Our guide to provider recredentialing walks through preparing early.
Behavioral Health, Dental, and Pharmacy
The steps above apply to the medical network. Cigna says behavioral health credentialing goes through Evernorth Behavioral Health, dental has its own process, and pharmacy credentialing is separate. If you offer more than one kind of service, confirm which application belongs to which line before you start, so you do not send the right documents to the wrong place.
Keeping Your Cigna Record Current
Approval is where the maintenance begins. Contracted providers update demographic changes through the Cigna for Health Care Professionals portal, so report moves, new locations, tax ID changes, and departures as they happen. Late changes are a steady source of directory errors and denied claims.
Each payer runs this a little differently. If you are credentialing with more than one, see our guides to Anthem, Aetna, and UnitedHealthcare. For Blue plans, begin with credentialing with Blue Cross Blue Shield and then read how BCBS credentialing differs by state.
Cigna Credentialing FAQ
What is Cigna credentialing?
Cigna credentialing is the process Cigna uses to verify a provider’s licenses, training, certifications, work history, and malpractice record before the provider joins its network. It confirms members are seen by qualified professionals.
How do I start Cigna credentialing?
Call 1-800-882-4462 and choose the credentialing option. Cigna tells you in most cases whether you meet its basic guidelines, and if you do, it emails you the application packet.
How long does Cigna credentialing take?
Cigna says it typically takes 45 to 60 days after it receives your completed packet. Preparing the packet and attesting in CAQH come first, so plan on more than two months from the day you begin. After approval, directory and claim system updates typically take about 10 business days.
Does Cigna use CAQH?
Yes. You can submit through CAQH, One Healthport/Medversant, or a state application, depending on your state. For CAQH, authorize Cigna to view your profile and keep your attestation current.
How do I check my Cigna credentialing status?
Email PSSCentral@Cigna.com with your full name and Taxpayer Identification Number, or call 1-800-882-4462 and choose the credentialing option.
How do I add a provider to an existing Cigna group?
Cigna’s public page does not describe a separate process, so call the credentialing line and ask what your group needs to send. The new provider will need their own profile or application, current licenses, and malpractice coverage, and should not see Cigna patients before the effective date.
How often does Cigna recredential providers?
Cigna does not state a cycle on its page. NCQA requires recredentialing every three years, and Cigna starts the process with an email asking you to verify and re-sign your CAQH information.
What happens if I ignore a Cigna recredentialing email?
Cigna sends up to three reminders. If you do not log in and complete the process, Cigna says it can result in termination from its network.
Summary: Let Medwave Run Your Cigna Credentialing
Cigna rewards a quick first call, a complete packet, and fast replies to its emails. Most delays start before the 45 to 60 day clock does, in a thin CAQH profile or a missing document.
Medwave handles credentialing, payer contracting, and medical billing for practices, so your Cigna application, your rates, and your claims stay connected. If you would rather hand the packet and the follow-up to a team that does this every week, contact us below and we will get started.
Co-Founder and COO of Medwave, bringing more than 25 years of hands-on experience in healthcare revenue cycle management, payer contracting, and medical credentialing.