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PO Box 15369 Springfield, Massachusetts 01115-5369 (877) 657-5030, TTY 711 www.wellfleetstudent.com Preferred PPO Provider Listings Cigna Claims Wellfleet Student www.wellfleetstudent.com or www.cigna.com Send Cigna claims to: CIGNA PO Box 188061 Chattanooga, TN 37422 – 8061 Electronic Payor ID: 62308 Prescription Drug ProviderPO Box 15369 Springfield, Massachusetts 01115-5369 (877) 657-5030, TTY 711 www.wellfleetstudent.com Preferred PPO Provider Listings Cigna Claims Wellfleet Student www.wellfleetstudent.com or www.cigna.com Send Cigna claims to: CIGNA PO Box 188061 Chattanooga, TN 37422 – 8061 Electronic Payor ID: 62308 Prescription … Claims should be addressed to CIGNA PPO (same address you already have listed). EDI Payer ID: 62308. Claims should be submitted to: Cigna PPO. PO Box 188061. Chattanooga, TN 37422-8061. See Claims for further information or contact the Student Health Insurance Office at 970-351-1915 or [email protected]. policy info.

PO Box 15369 Springfield, Massachusetts 01115-5369 (877) 657-5030, TTY 711 www.wellfleetstudent.com Preferred PPO Provider Listings Cigna Claims unco.myahpcare.com or www.cigna.com Send Cigna claims to: CIGNA PO Box 188061 Chattanooga, TN 37422 – 8061 Electronic Payor ID: 62308 Prescription Drug Provider Send it electronically with payer ID 62308. Or by mail to Cigna | PO Box 188061 | Chattanooga, TN 37422-8061. If your provider is within the Cigna + Oscar network and won’t submit your claim or hasn’t responded within 30 days, reach out to your Care Team. Submit All Claims to: CIGNA PO Box 188061 Chattanooga, TN 37422-8061 To locate a CIGNA network provider, go online to www.cigna.com or you may call Customer Service toll-free at (844) 206-0372. To get a prescription, your pharmacy will need the following information: *Your Member ID # Bin#: 012924 RxPCN: AMER9999Mail this completed form (Request for Health Care Professional Review) or a letter of appeal along with all supporting documentation to the address below: Cigna ID cards: If the Cigna ID card indicates: GWH -Cigna or ‘G’ on the front of the card: Cigna Appeals Unit Cigna Appeals Unit PO Box 188011 P.O. Box 188062 Chattanooga, TN 37422 ...

PO Box 188061 Chattanooga, TN 37422-8061 (EDI #62308) File claims within 30 days of Injury or first treatment for a Sickness or as soon as reasonably possible. Claim Forms are not required. Bills should be received by the Company within 90 days of service. Bills submitted after one yearPO Box 9040 Farmington, MO 63640-9040: Medi-Cal: Health Net Medi-Cal Claims PO Box 9020 Farmington, MO 63640-9020: Medicare Advantage: ... Farmington, MO 63640-9040: Cigna: Cigna PO Box 188061 Chattanooga, TN 37422: View Claims Details Online Providers Have Access to Claims Details 24/7. ….

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PO Box 188061 Chattanooga, TN 37422 - 8061 CIGNA HEALTH AND LIFE INSURANCE COMPANY Payment includes Cigna Health and Life Insurance Company insurance benefits and payments from FI BENEFIT SHARED SERVICES Health Reimbursement Account Customer service Call the number on the back of your ID card or 1-866-494-2111 MyCigna.comPO Box 188061 Chattanooga, TN 37422 – 8061 Electronic Payor ID: 62308 Prescription Drug Provider For information about the Wellfleet Rx/ESI Prescription Drug Program, please visit www.wellfleetstudent.com Your plan includes Wellfleet Rx – offering over 40 generics at a $0 copay. Please ask your health carePO Box 188061 Chattanooga, TN 37422-8061 Pediatric Vision Services Davis Vision Vision Care Processing P.O. Box 1525 Latham, NY 12110 Pediatric Dental Services LIBERTY Dental Electronic Payer ID: CX083 LIBERTY Dental Plan Attn: Claims Department P.O. Box 26110 Santa Ana, CA 92799 Provider Portal: www.libertydentalplan.com

P.O. Box 188011 Chattanooga, TN 37422-8011 Refer to your ID card to determine the appeal address to use below. Mail the completed Appeal Request Form or Appeal Letter …PO Box 188011 Chattanooga, TN 37422 Fax: 1.877.815.4827 • GWH-Cigna or “G” ID cards GWH-Cigna National Appeals PO Box 188062 Chattanooga, TN 37422-8062 Fax: 1.877.804.1679 1.800.444.4558 Clinical appeal Refer to the contact information received on the authorization or denial letter PO Box 15369 Springfield, MA 01115-5369 Phone: (833) 443-5338 Wellfleet Website. Open Access Plan (OAP) Network Cigna OAP PO Box 188061 Chattanooga, TN 37422-8061 EDI #: 62308 Cigna Website. Pharmacy Network Wellfleet Rx (888) 265-7884

daniel larson colorado PO Box 188061 Chattanooga, TN 37422-8061 Electronic Payor ID: 62308 For Non-Cigna PPO Providers: Wellfleet Group, LLC dba Wellfleet Administrators, LLC PO Box 15369 Springfield, MA 01115-5369 (877) 657-5030, TTY 711 www.wellfleetstudent.com Bills should be received by the Company within ninety (90) days of service. molina otc order online 2023connerton lennar P.O. Box 188061 Chattanooga, TN 37422-8061 HEALTH CLAIM FORM INSTRUCTIONS: THIS SIDE OF THE FORM MUST BE COMPLETED IN FULL. Attach this form to itemized bills for all expenses being claimed. The bills must show: Patient’s Name, Type of Service, Date(s) of Service(s), and the Total Charge. If you are submitting a surgical bill orPO Box 188061 Chattanooga, TN 37422-8061 Payer ID: 62308 CHP Providers submit claims to: Allegiance PO Box 3018 Missoula, MT 59806 Payer ID 81040 Other Providers submit claims to: Cigna PO Box 188061 Chattanoogna, TN 37422-8061 Payer ID: 62308 EAP - Health Management Systems of America - 1-800-767-5320 This card does not … super saiyan god goku and vegeta PO Box 15369 Springfield, Massachusetts 01115-5369 (877) 657-5030, TTY 711 www.wellfleetstudent.com Preferred PPO Provider Listings Cigna Claims Wellfleet Student www.wellfleetstudent.com or www.cigna.com Send Cigna claims to: CIGNA PO Box 188061 Chattanooga, TN 37422 – 8061 Electronic Payor ID: 62308 Prescription Drug Provider aspen dental christiansburg vamtd 753 08296 fan housing assemblywinnebago solis used for sale P.O. Box 188061 Chattanooga, TN 37422–8061 Cigna Group #: 1234567 Providers in SuperMed PPO Network (For services rendered in the state of Ohio, Campbell, Boone and Kenton counties in KY) Medical Mutual & SDC Claims Submission Electronic Claims Payer ID: 29076 & 31117 P.O. Box 6018, Cleveland, OH 44101–1018 CLT1 … sig p365 pocket holster MotivHealth is changing healthcare by focusing on HSA based insurance plans that produce lower premiums, better benefits and the ability for employees to build significant health savings. We believe informed, engaged and empowered clients are key to solving the high-cost issues of healthcare. ozempic 1mg penbaypath humane society of hopkinton hopkinton marobyn bell scituate 2077 Roosevelt Ave. Springfield MA 01104. 877.657.5030. www.wellfleetstudent.com. CIGNA. PO Box 188061. Chattanooga, TN 37422-8061. Electronic Payor ID: 62308. Lehigh University Student Health InsuranceNew Graduate students starting at Lehigh during the Summer term: Information on Summer coverage is available at: …