The Payor ID Issue (SX071)
We have had several e-mails from Therabill members telling us that Cigna Behavioral Health is telling them to submit to payor ID SX071. Our response has always been that SX071 is the payor ID from Cigna Behavioral Health in the Emdeon clearinghouse (which is the clearinghouse with the direct connect to Cigna). Therabill does not submit through Emdeon (otherwise there would be a 'per claim fee'). Therabill routes through Office Ally. The payor ID listed for Cigna Behavioral Health at Office Ally is CIGBH. Most likely, Office Ally is then changing the payer ID to SX071 and sending it on to Emdeon. Therabill does have to use the payor ID given to us by the clearinghouse that we submit directly to (which at this moment is Office Ally for Cigna Behavioral Health).
Cigna Behavioral Health is saying that we are submitting to the wrong payor ID.
More recently, we have received e-mails from Therabill members who say that they are getting correspondence from Cigna telling them that they are not receiving the claims because they are using the wrong payer ID. This raised an alarm here at Therabill. We talked with Office Ally and they told us the following.
- When we submit to them with payor ID CIGBH, they are forwarding it on using the correct payor ID (i.e. SX071).
- They said there is an issue either at Cigna or at Cigna's clearinghouse (Emdeon). They said this issue has happened before, where internally (either at Emdeon or at Cigna) they are not routing the claims correctly.
Office Ally recommends
Office Ally said that because this is a global issue (it is not only happening with claims submitted through Office Ally) that it could be a long standing issue with Cigna. If you are getting these types of errors, you may want to submit by paper.
What will Therabill do...
The first thing that Therabill would like to do is to make sure that it is not in fact an Office Ally issue. While we do believe Office Ally, Therabill would rather not tell you to submit by paper. Luckily, we do have another clearinghouse that we can send these claims through. We are going to switch Cigna Behavioral Health claims to route through the Availity clearinghouse. The payor ID listed by Availity is 02331.
What Therabill hopes happens...
We hope that submitting through Availity clears up the problem. But this would mean that the original issue was most likely at Office Ally and not at Cigna or Emdeon like Office Ally suggested. Therefore, we are not sure if this will work or not. We really hope so.
What you should do
If you have had problems with claims going to Cigna Behavioral Health, resubmit them. They will then go through the Availity clearinghouse. Do a claim status check approximately 3 days after you submit the claim to find out if the claim was routed correctly to Cigna Behavioral Health. Please keep Therabill informed with what is going on. The only way that Therabill can know what is going on with claims that are not electronically rejected is by you letting us know.
If the problem still persists...
Then it is most likely what Office Ally said. It is an issue at Cigna or at their clearinghouse and we can only sit and wait for them to get it fixed. We would then have to recommend that you do submit by paper until we hear the the issue has been resolved.