Beginning in mid-March, all Health Care Eligibility Inquiry Requests (ASC X12N 270 transactions) submitted to CignaHealthcare^® must include the National Provider Identifier (NPI).

This change aligns with the ASC X12N 270/271 (version 005010X279) standard and supports streamlined electronic data exchange. Additionally, including the NPI helps ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA) and enables more precise benefit responses.

What you need to know

• The NPI is required in NM109 with an “XX” qualifier in NM108.
• Transactions submitted without an NPI will return a 999 with a rejection.
• Taxpayer Identification Numbers (TINs) are permitted only for atypical providers.

Action required

• Confirm that all 270 transactions include the NPI in the correct segment.
• Monitor eligibility 271 responses received from your direct clearinghouse.

Providers should contact their direct clearinghouse for assistance updating their transaction format,  and can coordinate with their Cigna Healthcare trading partner relationship manager as needed.

Additional information

For more information about electronic data interchange vendors who partner with Cigna Healthcare, visit Cigna.com > Providers > Coverage and Claims > Claims Submission, Payments, and Filing > Electronic Data Interchange Vendors.

Tips on optimizing 270 transaction requests

These best practices can help reduce system busy responses and improve processing efficiency when submitting 270 eligibility requests:

• Include multiple Service Type Codes (STC) in one submission request for the same patient. This eliminates the need for sending back-to-back requests for each STC code individually, reducing unnecessary volume.

• Avoid redundant STC requests. When sending a general (e.g., 30) or a grouped STC request, no need to also request individual STCs already included in that group. Submitting both creates duplication and increases transaction volume.

• Avoid duplicate requests for the same patient by waiting for a response. Sending back-to-back requests with a different ID, name, or date of birth combinations creates unnecessary duplication. Try another combination if the patient is not found in the initial response.