Get Started Billing Electronically
So, you're ready to take advantage of the efficiency that EDI provides. Use the following guidelines to become an electronic biller.
- Evaluate your needs to start planning
- Begin the transition to billing electronically
- Choose your billing method and communications software
- Complete the EDI forms
- Test software compatibility
- Start billing electronically
IMPORTANT! Please read your documentation requirements carefully before proceeding with your planning.
Step One: Evaluate your needs to start planning
Develop specific measurable goals by assessing your current situation. Use the following guidelines to start the planning process.
- Assess how patient information and insurance claims, including Medicare, are currently handled in your office. Do you prefer to file all (Medicare, Medicaid, and commercial) insurance claims electronically?
- Decide which office functions should be automated, like patient accounts, accounts receivable, etc.
- If you currently use claims management software, contact your vendor to see if and how it can be expanded to be compatible with CIGNA Government Services and the other office functions you wish to automate.
- Decide on your implementation budget. Your investment will vary depending on the billing method selected.
TopStep Two: Begin the transition to billing electronically
Now that you have completed your evaluation, it is time to begin the setup process. The first available features in this process are:
- Electronic Media Claims
- Electronic Receipt Listings - NOTE: This feature is automatic.
- 997 Functional Acknowledgement Reports - Note: This feature is automatic.
Once you are enrolled and active in electronic billing, you may select other features. Look over our list of products and services to choose the features that match your needs. Use the technical requirements table to help you and your technical staff or software vendor ensure that you have the appropriate software for each.
Step Three: Choose your billing method and communications software
Electronic Media Claims (EMC) may be transmitted to CIGNA Government Services using various billing methods and communications software packages. First, you must decide whether you'll bill directly to CIGNA Government Services or through a third party service.
Directly to CIGNA Government Services
- Billing software
If you bill directly to CIGNA Government Services, choose one of the following:
- Communications software
Communications software is required to transmit your data via Stratus, CIGNA Government Services's asynchronous electronic network. Ask your software vendor to confirm that your billing software includes communications capabilities (CIGNA Government Services's free billing software does not). If not, you will need to purchase such software, available at most software retail stores. Examples include HyperTerminal (provided by Microsoft on Windows 95 or higher), or any other operating system that provides communication.
Through a third party service
You may contract with a third party entity to assist in your billing and transmission needs.
Step Four: Complete the EDI forms
In order to transmit claims to CIGNA Government Services you must complete the EDI Customer Profile and the EDI Enrollment Form.
Step Five: Test software compatibility
As a precaution, CIGNA Government Services may require new software vendors, billing services, and clearinghouses to test their software before claims are transmitted for payment. EDI Technical Analysts are available to discuss the testing process.
- Part
B Testing Packet
(691K) - Part
B Companion Document/Trading Partner Agreement (25K)
- Communication
Application For Testing (29K)
Step Six: Start billing electronically
Once you have passed your testing phase (if applicable) and our office has your signed EDI Enrollment Form and EDI Customer Profile on file, you are ready to begin transmitting claims for payment.
Claims may be transmitted to CIGNA Government Services 24 hours a day 7 days a week, excepting for times when maintenance is necessary. Such occurrences will be announced via our Web site and through our ListServ. Claims are processed each business evening with the exception of dates when quarterly software update releases are implemented (generally on or around the 1st weekend of January, April, July, and October), and Electronic Receipt Listings (ERLs) will be available the following day for all claims received by 5:00 pm Eastern time on any business day.
