Po box 188061 chattanooga tn 37422 8061
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P.O. Box 188061 Chattanooga, TN 37422-8061 Payer ID 62308 Submit Claims to: Cigna PO Box 188061 Chattanooga, TN 37422-8061 Payer ID: 62308 We encourage you to use a PCP as a valuable resource and personal health advocate. This card does not guarantee eligibility or payment. Member Medical Plan Covered Person: JOHN SAMPLE Reid Hospital Group ID ...
We would like to show you a description here but the site won’t allow us.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 …PO 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 P.O. Box 26110 Santa Ana, CA 92799 Prescriptions/ SpecialtyP.O. Box 3018 Missoula, MT 59806-3018 Toll Free: 800-877-1122 Local: 406-721-2222. Companies Allegiance Benefit Plan Management, Inc. Allegiance Advantage Allegiance ...Jan 4, 2016 · PO Box 188061 Chattanooga, TN 37422-8061 or Payer ID: 62308 Cigna will forward priced claims to Allegiance electronically for processing. Claims submitted electronically will be accepted or rejected based on an eligibility match. If rejected, the provider will receive a 999 response file. 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 (2022_MM_PPO_Outside Ohio ... BOX 188061 CHATTANOOGA, TN. 37422. CIGNA HEALTH ... PO.BOX 2157 SAN LEANDRO, CA. 94577. CONVENTRY ... 37422-8061. GROUP HEALTH. PO. BOX 34585 SEATTLE, WA. 98124.
P.O. Box 188061 Chattanooga, TN 37422-8061 Electronic Payer ID: 62308. Note: Claims submitted directly to Wellfleet Student will be denied and you will be asked to resubmit them to CIGNA.P.O. Box 188061. Chattanooga, TN 37422-8061. Electronic Payor ID: 62308. If you receive treatment from an Out-of-Network provider, you may be required to pay ...Oct 7, 2022 · Want to More Know about electronic claims submission Contact the Following SIGNA Helpline: 1-800-882-4462. For Cigna Paper Claims Mailing Address Please look at the back side of Your Member identity card or you can submit claims to the Following Cigna Claims address: PO field 182223. Chattanooga, TN 37422-72223. 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 Medical Pre‐Certification / Pre‐treatment Review Allegiance Care Management (800) 342‐6510 Fax numbers below: For pretreatment review: 406‐532‐3513 Home Health/Hospice: 406‐532‐1502 For Inpatient Certs: Medical 406‐532‐1501
Bills for medical services should be submitted to Cigna, PO Box 188061, Chattanooga, TN 37422-8061. Can my spouse and children be covered under the student insurance? No. Are there different times you can purchase the insurance besides fall and spring? Yes. Please see the Enrollment Form or Brochure for the details of coverage periods.Nov 6, 2023 ... EDI Payer ID: 62308. Claims should be submitted to: Cigna PPO PO Box 188061. Chattanooga, TN 37422-8061. See Claims for further information or ...PO Box 188061. Chattanooga, TN 37422-8061. Electronic Payor ID: 62308. For Non-Cigna PPO Providers: Wellfleet Group, LLC dba Wellfleet Administrators, LLC PO ...All claims will be processed by Allegiance at its facility in Missoula, MT. Checks and EOBs will come from Allegiance. EFT/835. Zelis. (877) 828-8770. [email protected]. Working with Allegiance. Confidential, unpublished property of Allegiance Benefit Plan Management, Inc. Do not duplicate or distribute.
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Medical Claims: PO Box 188061 Chattanooga, TN 37422-8061 Payer ID #62308 Rx Claims: Connecticut General Life Insurance Company, Pharmacy Service Center, PO Box 188053, Chattanooga, TN 37422-8053 Member and Pharmacy Helpline: 800-325-1404 Benefits are not insured by Cigna oraffiliates. Confidential, unpublished property of Cigna.PO Box 188014 Chattanooga, TN 37422. Created Date: 7/21/2021 8:17:14 AM ... 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. PO Box 188061 Chattanooga, TN 37422-8061 Electronic Payor ID: 62308. Non-Cigna PPO Providers Wellfleet Group, LLC dba Wellfleet Administrators, LLC PO Box 15369 Springfield, MA 01115-5369. Bills should be submitted within ninety (90) days of service. Keep copies of all the documents you submit.Payer ID 95567, PO Box 9040 Farmington, MO 63640-9040 Outside of California Medical & Mental Health Benefit Claims Cigna Medical Claims Payer ID 62308, PO Box 188061 Chattanooga, TN 37422-8061 Health Net of California, Inc. provides the health benefits under this plan Benefits are not insured by Cigna or affiliates
Bills for medical services should be submitted to Cigna, PO Box 188061, Chattanooga, TN 37422-8061. Can my spouse and children be covered under the student insurance? No. Are there different times you can purchase the insurance besides fall and spring? Yes. Please see the Enrollment Form or Brochure for the details of coverage periods.PO Box 188061 Chattanooga, Tennessee 37422-8061 Electronically: Payer ID: 62308 You can also refer to the patient’s ID card for claim submission information. Do I need to collect the customer’s deductible or coinsurance at the time of service? No. Send your claims to Cigna for processing. Medical Claims PO Box 188061 Chattanooga, TN 37422-8061 Payer ID #62308 Rx Claims: Pharmacy Service Center, PO Box 188053, Chattanooga TN 37422-8053 For Pharmacists Only 800-351-9170 Customers & Health Care Professionals call 1-866-494-2111 R418A (8/13) Mask 601 Issue Date: 10/31/14 Open Access Plus Away From Home Care LocalPlus myCigna.com Medical Claims: PO Box 188061 Chattanooga, TN 37422-8061 Payer ID# 62308 ... Pharmacy Service Center PO Box 188053 Chattanooga, TN 37422-8053 Member and Pharmacy Help Line: 800-325-1404 Benefits are not Insured by Cigna or affiliates. OnCall Global Assistance Center: (Toll Free) 1- 855-226-7915 (Collect) 1-603-952-2045 po box 188061 chattanooga, tn 37422-8061 active retired laid off disability leave other employee name: (please print first name, middle initial, last name social security no. marital status. single married divorced widowed legally separated street address: (street, city, state, zip code) date of birth: month/day/year 2806 S. Garfield St. P.O. Box 3018 Missoula, MT 59806 ... PO Box 188061 Chattanooga, TN 37422-8061 Payer ID 62308 Allegiance Online Verification of Benefits:PO Box 182273 Chattanooga, TN 37422 (866) 449-6849 . Your Personal Information* Member name: Parent or authorized representative: Member Medicaid ID and subscriber number: Pr efe r d pho numb r: *If any of your contact information has changed, call the enrollment broker at 800-964-2777 or Molina at (866) 449-6849. Your Authorized …PO Box 188061 . Chattanooga, TN 37422-8061 . Payer ID: 62308 . Medical Mutual SuperMed PPO network. Services rendered in Ohio, and Campbell, Boone and Kenton counties in Kentucky Medical Mutual Claims . PO Box 6018 : Cleveland, OH 44101-1018 . Payer ID: 29076 . Sample ID cards – For illustrative purposes only. 1.For routine follow-up, please use the Claims Follow-Up Form instead of the Health Care Professional Dispute Resolution Form. Mail the completed form to: California Health Care Professional Dispute Resolution Request Cigna If GWH -Cigna or ‘G’ is listed on the front of the card: PO Box 188011 PO Box 188062 Chattanooga, TN 37422 Chattanooga ...
PO Box 188061 Chattanooga, TN 37422-8061 Claim Disputes Cigna Administered by Oscar c/o Oscar Management Corporation PO Box 52146 ... PO Box 52146 Phoenix, AZ 85072-2146 Sample ID Cards Member ID cards will include details about the network the plan aligns with and will look like the
Get ratings and reviews for the top 7 home warranty companies in Chattanooga, TN. Helping you find the best home warranty companies for the job. Expert Advice On Improving Your Hom...PO Box 188081 Chattanooga, TN 37422 Fax #: 855-350-8671 For all Non Contracted Provider Appeals a completed Waiver of Liability is required in order to process your appeal. The Waiver of Liability Statement must be signed. Your appeal request will not be considered without receipt of a signed Waiver of Liability Statement. You can either mail ...Many people and businesses use PO boxes to send and receive mail. A PO box can provide a convenient way of receiving mail, but it is not valid for many applications where a residen...PO Box 188061 Chattanooga, TN 37422-8061 The Cigna PPO Network is only applicable to Oregon fully-insured plans and self-insured ASO groups with access to the Cigna network. Connect plans only have access to Cigna contracted rates and applies to the out-of-network benefit. It is not available to members on a Washington plan.PO Box 188014 Chattanooga, TN 37422. Created Date: 7/21/2021 8:17:14 AM ...Home. > Providers. > CIGNA PPO. Claims Auditing. National Provider Identifier Requirements. Claim Submission. Find a Doctor or Hospital. CIGNA PPO. EDI Payor ID: … Medical Claims PO Box 188061 Chattanooga, TN 37422-8061 Payer ID #62308 Rx Claims: Pharmacy Service Center, PO Box 188053, Chattanooga TN 37422-8053 For Pharmacists Only 800-351-9170 Customers & Health Care Professionals call 1-866-494-2111 R418A (8/13) Mask 601 Issue Date: 10/31/14 Open Access Plus Away From Home Care LocalPlus myCigna.com 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 188061 Chattanooga, TN 37422-8061. Mental Health and Substance Use Disorder Claims: Cigna Healthcare Behavioral Health, Inc. Attn: Claims Service Dept. P.O. Box …Many people and businesses use PO boxes to send and receive mail. A PO box can provide a convenient way of receiving mail, but it is not valid for many applications where a residen...
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PO 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 care provider to review ourP.O. Box 188061. Chattanooga, TN 37422–8061. Cigna Group #: 1234567. Providers in SuperMed PPO Network. (For services rendered in the state of Ohio, Campbell ...P.O. Box 6018, Cleveland, OH 44101–1018. Providers not in SuperMed PPO Network. (For ... P.O. Box 188061. Chattanooga, TN 37422–8061. Cigna Group #: 1234567.All claims will be processed by Allegiance at its facility in Missoula, MT. Checks and EOBs will come from Allegiance. EFT/835. Zelis. (877) 828-8770. [email protected]. Working with Allegiance. Confidential, unpublished property of Allegiance Benefit Plan Management, Inc. Do not duplicate or distribute.Springfield MA 01104 877.657.5030 www.wellfleetstudent.com, CIGNA PO Box 188061. Chattanooga, TN 37422-8061. Electronic Payor ID: 62308. Bursar's Office.great west health (cigna) po. box 188061 chattanooha, tn. 37422-8061 group health po. box 34585 seattle, wa. 98124 hawaii manland adminstrators 1600 broadway rd suite 300 tempe, az. 85282 ... wph allegiance (cigna) po. box 188061 chattanooga,tn. 37422 zenith american solution (nm pipe trades now called ) 4520 montgmery ne albuq, nm 87108PO Box 188061 Chattanooga, TN 37422-8061 Behavioral Health and Substance Abuse Services Evernorth Behavioral Health, Inc. Electronic Payer ID: 62308 Cigna + Oscar PO 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 DentalPO 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 year will not be ….
Sep 13, 2018 ... PO Box 188061. Chattanooga, TN 37422-8061. Payer ID: 62308. 270/271 Transactions-Payer ID 81040. We encourage you to use a PCP as a valuable ...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: AMER9999PO Box 188061. Chattanooga, TN 37422 – 8061. Electronic Payor ID: 62308. Prescription Drug Provider. For information about the Wellfleet Rx/ESI Prescription.CIGNA PPO. EDI Payor ID: 62308. Mail Claims to: CIGNA PPO. P.O. Box 188061. Chattanooga, TN 37422-8061. 110314. American Republic Insurance Company - Founded in 1929, we have a proven track record providing exceptional insurance solutions.P.O. Box 272540 Chico, CA 95927-2540. More information about claim submission can be found on the Blue Shield website: For services outside California, submit claims to Cigna PPO Network. Electronic Submission via EDI. Paper Claim Mailing Address: Cigna PO Box 188061 Chattanooga, TN 37422-8061. Electronic Funds Transfer (EFT) Claim PaymentsPO 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.comPO Box 188061 Chattanooga, TN 37422-8061 The Cigna PPO Network is only applicable to Oregon fully-insured plans and self-insured ASO groups with access to the Cigna network. Connect plans only have access to Cigna contracted rates and applies to the out-of-network benefit. It is not available to members on a Washington plan.Payer ID 95567, PO Box 9040 Farmington, MO 63640-9040 Outside of California Medical & Mental Health Benefit Claims Cigna Medical Claims Payer ID 62308, PO Box 188061 Chattanooga, TN 37422-8061 Health Net of California, Inc. provides the health benefits under this plan Benefits are not insured by Cigna or affiliates Po box 188061 chattanooga tn 37422 8061, Bills for medical services should be submitted to Cigna, PO Box 188061, Chattanooga, TN 37422-8061. Can my spouse and children be covered under the student insurance? No. Are there different times you can purchase the insurance besides fall and spring? Yes. Please see the Enrollment Form or Brochure for the details of coverage periods., Benefits administration is challenging for health insurance brokers and small business owners who want to offer quality employee benefits., 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: AMER9999, Jan 4, 2016 · PO Box 188061 Chattanooga, TN 37422-8061 or Payer ID: 62308 Cigna will forward priced claims to Allegiance electronically for processing. Claims submitted electronically will be accepted or rejected based on an eligibility match. If rejected, the provider will receive a 999 response file. , Oct 27, 2023 · PO Box 9030 Farmington, MO 63640-9030: Salud con Health Net: ... Farmington, MO 63640-9040: Cigna: Cigna PO Box 188061 Chattanooga, TN 37422: View Claims Details Online , , PO Box 188037 Chattanooga, TN 37422-7223: Cigna Mailing Address for Vision Claima: PO Box 385020 Birmingham, AL 35238-5020: To contact BCBS provider customer service, you will need to check BCBS prefix list to reach the correct home plan. Cigna Fax Number for Claim Appeals., CHATTANOOGA. TN. 37415. AEL - MEMPHIS. PO BOX 586. ARLINGTON. TN ... PO BOX 188061. CHATTANOOGA. TN. 37422-8061. CIGNA ... TN DEPT. OF COMMERCE & INSURANCE., PO 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 care, Payer ID 95567, PO Box 9040 Farmington, MO 63640-9040 Health Net of California, Inc. provides the health benefits under this plan Outside of California Medical & Mental Health Benefit Claims Cigna Medical Claims Payer ID 62308, PO Box 188061 Chattanooga, TN 37422-8061 Benefits are not insured by Cigna or affiliates Access may vary . …, We would like to show you a description here but the site won’t allow us., Medical Claims PO Box 188061 Chattanooga, TN 37422-8061 Payer ID #62308 Rx Claims: Pharmacy Service Center, PO Box 188053, Chattanooga TN [PDF] Contact Information - Cigna P O Box 188011 Chattanooga, TN 37422 Fax: 1 877 815 4827 1 866 494 2111 Cigna GWH-Cigna National Appeals P O Box 668 Kennett, MO 63857, PO BOX 188061 Chattanooga, TN 37422-8061 PRESCRIPTIONS MaxorPlus Rx BIN: 005377 Rx PCN: 10000019 Rx GRP: 11800 Customer Service: (800) 687-0707 www.maxorplus.com Direct questions regarding eligibility, benefits, or claim status to: 90 DEGREE BENEFITS POBox 54139 Lubbock, TX 79453-4139 Customer Service: …, What's 37422-8000? 37422-8000 is a ZIP Code 5 Plus 4 number of PO BOX 188000 (From 188000 To 188099), CHATTANOOGA, TN, USA. Below is detail information., PO Box 188061 Chattanooga, TN 37422-8061 Electronic Payor ID: 62308. Non-Cigna PPO Providers Wellfleet Group, LLC dba Wellfleet Administrators, LLC PO Box 15369 Springfield, MA 01115-5369. Bills should be submitted within ninety (90) days of service. Keep copies of all the documents you submit., 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 Insurance Check out our Student Health Insurance Frequently Asked Questions., Cigna, PO Box 188061, Chattanooga, TN 37422-8061 Electronic Payor ID: 62308 Eligibility/Claims: (877) 657-5030 Please submit all Medical, Dental, other non-medical claims, and correspondence to: Wellfleet Group, LLC, PO Box 15369, Springfield, MA 01115-5369 Electronic Payor ID: 87843 ., 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, Medical Claims PO Box 188061 Chattanooga, TN 37422-8061 Payer ID #62308 Rx Claims: Pharmacy Service Center, PO Box 188053, Chattanooga TN 37422-8053 For Pharmacists Only 800-351-9170 Customers & Health Care Professionals call 1-866-494-2111 R418A (8/13) Mask 601 Issue Date: 10/31/14 Open Access Plus Away From Home …, 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 , PO Box 15369 Springfield, Massachusetts 01115-5369 (877) 657-5030 www.wellfleetstudent.com Preferred PPO Provider Listings Cigna Claims Wellfleet Student www.wellfleetstudent.com or Cigna Open Access Plus (OAP) www.cigna.com Send Cigna claims to: CIGNA OAP PO Box 188061 Chattanooga, TN 37422 – 8061 Electronic …, 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 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, Jan 1, 2014 ... P.O. Box 3018. Missoula, MT 59806. Payer ID:81040. All other providers submit claims to: CIGNA. P.O. Box 188061. Chattanooga, TN 37422-8061., PO 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 …, Jan 1, 2014 ... PO Box 188061 Chattanooga, TN 37422 - 8061. Name John Doe. Cigna ... Submit/mail claims to: Cigna Payor 62308, PO Box 188004, Chattanooga, TN ..., PO 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 …, 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, PO Box 188061 Chattanooga, TN 37422-8061 www.cigna.com You can confirm a provider is participating in the Cigna PPO network by calling: 877.657.5039. Pre-Certification is required for the following services: All Inpatient Hospitalization, High Risk Maternity, Routine Maternity (if Inpatient stay exceeds federal, PO 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 care, Cigna, PO Box 188061, Chattanooga, TN 37422-8061 Electronic Payor ID: 62308 Eligibility/Claims: (877) 657-5030 Please submit all Medical, Dental, other non-medical claims, and correspondence to: Wellfleet Group, LLC, PO Box 15369, Springfield, MA 01115-5369 Electronic Payor ID: 87843 ., Mail 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 Electronic Payor ID: 62308. Non-Cigna PPO Providers Wellfleet Group, LLC dba Wellfleet Administrators, LLC PO Box 15369 Springfield, MA 01115-5369. Bills should be submitted within ninety (90) days of service. Keep copies of all the documents you submit.