Cigna Healthcare
Cigna Healthcare / Cigna Health and Life Insurance Company · The Cigna Group (parent: Evernorth Health Services) · NAIC 67369
Where to send the appeal
Verified addresses and inbound channels. We refresh on every release.
Response timeline
The clocks that matter. Miss them and you escalate to the state insurance commissioner.
Codes worth fighting
Based on outcome data across our payer corpus.
- CO-97
- CO-4
- CO-167
- CO-204
- CO-18
- CO-50
- CO-29
- PR-1
Modifier behavior
The denials this payer applies on modifier-bearing claims. The rebuttal language is part of the Denial OS letter generator and not published here.
Modifier 25
Significant, Separately Identifiable E/M ServiceCigna applies clinical edits on modifier 25 with documentation requirements above CPT baseline. Often denied as CO-4 or CO-97 when E/M is billed same day as procedure.
Modifier 59
Distinct Procedural ServiceCigna's editing engine generally honors NCCI-compliant modifier 59 use; denials on 59 typically signal documentation gaps, not policy misalignment.
Interest statute
The legal basis for charging interest when payment runs late.
Varies by state — typically state prompt-pay statute applies to fully-insured products; ERISA §503 applies to self-funded products administered by Cigna
You have the playbook. Now write the letter.
Paste your EOB and Denial OS generates the appeal in five minutes — citing the contracted rate, the modifier rebuttal, and the deadline statute that matches this exact payer.
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