New Claim Status Workflow

Health Plans: 

  • Cigna

Workflow: 

  • Claim Status

Beginning in April 2017, Cigna will be transitioning its old Claim Status Inquiry transaction to the new NaviNet Open Claim Status workflow. You will enjoy the same comprehensive claims information you've come to expect, but in a more streamlined, easier-to-use workflow.

The new Claim Status workflow includes:

  • A simple-to-use Claim Search screen that includes a Billing Entity box that searches as you type.
  • A simplified patient data entry section.
  • New calendar widgets for easier date entry.
  • A Claim Status Details screen that is easy to read and digest at a glance.
  • An enhanced View/Print feature that lets you print all of the claim details.
  • A new help viewer that provides additional information on the workflow.

Claim Status

You can access the new Claim Status workflow as you always have, under Workflows for This Plan on the Plan Central screen. To get to the Plan Central screen, first login to NaviNet. Sign in to NaviNet. On the Workflows menu, select My Health Plans, and select Cigna.

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Under Workflows For This Plan, click Claim Status Inquiry. A new Claim search opens. 

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Claim Search Screen

The screenshot below highlights the features of the new Claim Search screen. In the Billing Entity search field, once you start typing, an automatic search is performed and a list of providers drops down.  

In additon, Cigna has now enabled users to search in the past for a date of service. Cigna supports a service search of up to two years in the past, or 730 days from the day of the claim search. Now you can easily select a date from the new Date entry widget.

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Claim Status Search Results Screen

If more than one claim matches the search criteria, the Claim Status Search Results screen appears. The Status column is color coded and uses icons to inform you of claim statuses at a glance.

To see the Claim Status Details screen of a particular claim, click the Claim ID on the left of the table.

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If you do not see your claim in the search results, click Back to Claim Status Search to change your search criteria.

 

Claim Status Details Screen

Once you have selected the Claim ID from the search screen, a window opens with the Claim Status Details. The Claim Status Details screen shows the status of the claim on the color-coded claim status bar. You'll see a summary of the claim, including the total amount billed and paid, at the top of the screen and service line details at the bottom of the screen. Use the View/Print link to print the contents of the screen.

Additionally, located at the bottom of the Additional Details Box, there is a link to the Eligibility and Benefits for the claim. 

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