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Denial OS
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Payer playbook · National

Cigna Healthcare

Cigna Healthcare / Cigna Health and Life Insurance Company · The Cigna Group (parent: Evernorth Health Services) · NAIC 67369

01

Where to send the appeal

Verified addresses and inbound channels. We refresh on every release.

Fax
+1-877-815-4827
Mailing address
Cigna — National Appeals Organization P.O. Box 188011 Chattanooga, TN 37422-8011
02

Response timeline

The clocks that matter. Miss them and you escalate to the state insurance commissioner.

First-level response
30 days
Second-level response
30 days
Provider appeal window
180 days
Expedited pathway
72 hours
03

Codes worth fighting

Based on outcome data across our payer corpus.

Known win codes
  • CO-97
  • CO-4
  • CO-167
  • CO-204
  • CO-18
Known difficult codes
  • CO-50
  • CO-29
  • PR-1
04

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 Service

Cigna 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.

Recommended rebuttal language is part of the Denial OS letter engine — start a free appeal to see it in context.

Modifier 59

Distinct Procedural Service

Cigna's editing engine generally honors NCCI-compliant modifier 59 use; denials on 59 typically signal documentation gaps, not policy misalignment.

Recommended rebuttal language is part of the Denial OS letter engine — start a free appeal to see it in context.
05

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.

Start your appeal