RECREDENTIALING: WHAT YOU NEED TO KNOW

CIGNA re-credentials its participating behavioral practitioners every three years in order to ensure network quality. Practitioners must consistently meet established credentialing standards. If re-credentialing is not completed in a timely manner, then the contract is terminated.

At that point, the practitioner has the option to remain non-participating or to reapply to the network. Network re-acceptance is not guaranteed, but is contingent upon several factors, such as the number of current participants, specialties, geographical need, and compliance history with the re-credentialing process.

The best way to avoid contract/coverage problems and help minimize the effect of any unexpected errors or delays is to complete your re-credentialing application as early as possible.

Items to Note:
• CAQH (Council for Affordable Quality Healthcare): contracted practitioners are required to re-attest to their CAQH profile information every 120 days (www.caqh.org).
• Aperture/Ingenix is the primary source verification company CIGNA's behavioral program uses to verify practitioners’ credentials. Aperture utilizes the information in the practitioner’s CAQH profile.
• Practitioners are sent 3 reminder notices, starting 6 months in advance of their re-credentialing due date, from either CAQH or Aperture.
• 4 months prior to the due date, practitioners are also sent a certified letter from CIGNA notifying them that if they do not complete their re-credentialing within the required timeframe, their contract will be terminated.

We encourage practitioners to contact the appropriate CIGNA Provider Relations staff for inquiries related to their re-credentialing should they need assistance.

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If you have topics you'd like to see addressed here please let us know. Contact us at behprep@cigna.com and we'll dig into them. We want this brief to be as informative and insightful as possible and to address topics important to our practitioner community.