Cigna has long partnered with American Specialty Health (ASH) to manage networks of specialty therapy providers. ASH is a nationally accredited contractor (URAC and NCQA certified) that handles Cigna’s network management, credentialing, and claims processing for rehabilitation services. In fact, ASH has been contracted with Cigna for over 30 years. Recently, Cigna expanded ASH’s role into many new states, meaning that providers in those areas must contract with ASH to serve Cigna members.
What Therapy Providers Need to Know
- ASH Network Role: ASH acts as the delegated network for Cigna’s therapy benefits. If your Cigna patients’ plan is managed by ASH, you must credential through ASH’s network (often via ASHLink) rather than Cigna’s direct portal.
- Credentialing Standards: ASH’s credentialing process is NCQA-certified. You will need current state licensure, National Provider Identifier (NPI), proof of liability insurance, and a full education/work history. Disclose any disciplinary actions or employment gaps. Missing or expired documents will stall the application.
- CAQH Profile: ASH participates in CAQH. Ensure your CAQH profile is complete, attested, and authorized for ASH. If ASH cannot pull your CAQH data, you may need to submit credentials directly.
- Application Process: Providers apply via ASHLink or by contacting ASH provider relations. Submit all required paperwork and authorizations together. If everything is in order, credentialing often takes 45–60 days, though delays can occur if ASH requests clarifications.
- Network Size: ASH maintains a large therapy network. For example, ASH has contracted over 53,000 PT/OT practitioners nationwide, offering broad access for Cigna members when you join.
- Speech Therapy: Note that Cigna’s 2023 ASH expansion covered physical and occupational therapy only; speech-language pathology was explicitly excluded. SLPs should confirm whether ASH credentialing applies to their practice or if a different process is needed.
- State-by-State Updates: ASH coverage varies by region. In states added in 2023 (for example, Illinois, North Carolina, etc.), ASH contracting is required for network participation. Always verify with Cigna if ASH applies to your specific plan or region.
Why Get a Credentialing Partner to Expedite Your Enrollment
For PTs, OTs, and SLPs joining Cigna’s delegated ASH therapy network, navigating the credentialing and enrollment process can be complex and time-consuming. Missing documents, incomplete CAQH profiles, inconsistencies in work history, or delayed responses to deficiency requests are common causes of enrollment delays. A credentialing partner like Prime Credential helps address these challenges by auditing all credentials, ensuring licenses and liability coverage are current, and verifying that CAQH profiles are complete, attested, and accessible to ASH. Early identification of potential issues prevents application holds and helps providers move through the credentialing process smoothly.
Beyond initial enrollment, maintaining compliance and staying in-network requires ongoing attention. Prime Credential supports therapy providers by tracking all communications with ASH, sending reminders for recredentialing, and assisting with updates to documentation whenever payer criteria change. This proactive management ensures that applications and renewals are submitted correctly and on time, reducing administrative burden and protecting patient access. Partnering with a credentialing expert not only streamlines approvals but also provides peace of mind, making it easier for PTs, OTs, and SLPs to focus on delivering care rather than managing paperwork.
Why Choose Prime Credential
Navigating Cigna enrollment and credentialing can be complex and time-consuming, especially for therapy providers. Prime Credential specializes in helping PTs, OTs, and SLPs streamline this process and successfully join the Cigna network. Here’s why clinics choose Prime Credential:
- Expertise in Cigna Therapy Enrollment: Prime Credential understands Cigna’s specific requirements for rehabilitation and therapy services, including cross-division reviews, peer screenings, and preliminary screening forms.
- Faster Application Processing: By auditing credentials, completing Cigna applications correctly, and proactively tracking status, Prime Credential can help reduce delays often caused by missing or inconsistent documentation.
- CAQH and Cigna Portal Management: Prime Credential ensures your CAQH profile is attested, released, and up-to-date so Cigna can access it seamlessly, avoiding common roadblocks.
- Ongoing Support for Cigna Network Providers: From initial enrollment to periodic recredentialing required by Cigna, Prime Credential provides guidance, reminders, and troubleshooting assistance.
- Peace of Mind: With a dedicated team monitoring submissions, deficiency requests, and communications with Cigna, therapy providers can focus on patient care rather than paperwork.
Frequently Asked Questions (FAQs)
1. What documentation is required if I’ve practiced at multiple clinics?
You’ll need a complete work history for each practice, including dates, addresses, and supervisor details. Any gaps should be clearly explained to prevent credentialing delays.
2. Can I update my application after submission?
Yes. You can submit additional documents or corrections via the Cigna provider portal or by contacting the credentialing team directly. Always log updates to ensure tracking.
3. How do I know if my specialty requires extra screening?
Therapy services may undergo additional review if they fall under behavioral health, rehabilitation, or certain specialty divisions. Contact your Cigna provider relations representative to confirm requirements.
4. Are there fees associated with joining Cigna?
Generally, there are no fees to submit a provider enrollment application. However, malpractice insurance, state licensure, or other certifications may involve separate costs.
5. Does Prime Credential assist with recredentialing?
Yes. The team provides reminders and support for recredentialing every three years or as required, ensuring continued in-network status without interruption.
