Cigna Dental Payment Reconciliation: Portal Tips and ERA Matching

Cigna deposited $8,432.17 yesterday. The description just says "CIGNA." Here is how to figure out exactly what patients and procedures that payment covers.

Understanding Cigna Dental Payments

Cigna is one of the largest dental insurance carriers, covering millions of Americans through employer plans and individual policies. For many dental practices, Cigna payments represent a significant portion of insurance revenue.

Like other major payers, Cigna sends payments as lump sums covering multiple patients and claims. Reconciling these payments requires matching the deposit to the corresponding Electronic Remittance Advice and verifying that amounts post correctly to patient accounts.

This guide walks through Cigna-specific reconciliation, including navigating their provider portal, understanding their ERA format, and handling common issues.

How Cigna Payments Arrive

EFT (Electronic Funds Transfer)

Most Cigna payments arrive via EFT directly to your bank account.

Bank description: Typically appears as "CIGNA" or "CIGNA HLTH" with a trace number.

Timing: EFTs usually process 1-2 business days after Cigna releases payment.

Enrollment: You must enroll in EFT through Cigna's provider portal or through a clearinghouse to receive electronic payments.

Paper Checks

Some practices still receive paper checks, especially if not enrolled in EFT.

Processing: Checks arrive by mail with an accompanying EOB.

Recommendation: Enroll in EFT to receive payments faster and reduce lost check risk.

Virtual Credit Cards

Cigna may offer virtual credit card payments. Be aware of processing fees before accepting.

Consideration: Processing fees on virtual cards can be 2-3%, significantly reducing your effective payment.

Recommendation: Decline virtual card payments and request EFT instead if possible.

Navigating the Cigna Provider Portal

Accessing the Portal

Cigna's provider portal is called CignaforHCP (Cigna for Health Care Professionals).

URL: https://cignaforhcp.cigna.com

Registration: If not already registered, you will need your Tax ID and practice information to create an account.

Multiple users: Set up accounts for staff who need access, with appropriate permission levels.

Finding Payment Information

Once logged in, navigate to payment and remittance information.

Path: Claims & Payments → Payment Search or Remittance

Search options:

By payment date range
By check/EFT number
By payment amount
By patient name

Downloading ERAs

Cigna provides ERAs through the portal.

To download:

Navigate to the payment you want to reconcile
Select "View Remittance" or "Download ERA"
Choose format (835 file or PDF)

For bulk downloads: Some practices download all ERAs for a date range and process them together.

ERA Delivery Options

You can also receive Cigna ERAs through:

Clearinghouse: Configure your clearinghouse to receive Cigna ERAs automatically. This is often the most efficient method.

Direct connection: Larger organizations may establish direct ERA feeds.

Check your clearinghouse settings to ensure Cigna ERAs are being routed correctly.

Matching Cigna EFTs to ERAs

Step 1: Identify the Deposit

Find the Cigna deposit in your bank account.

Note:

Exact deposit amount
Deposit date
Any trace number visible in bank description

Step 2: Search for Matching ERA

Search for an ERA that matches your deposit.

In clearinghouse:

Search by date range (payment date may be 1-2 days before deposit date)
Search by amount
Filter by payer (Cigna)

In Cigna portal:

Use payment search
Enter amount or date range
Look for matching trace number

Step 3: Verify the Match

Confirm the ERA matches your deposit.

Check:

Does ERA total exactly match deposit amount?
Is the trace/check number consistent?
Does the timing make sense?

If the ERA total does not match the deposit exactly, investigate before posting.

Step 4: Review ERA Contents

Before posting, review what the ERA contains.

Verify patients:

Are all patients on the ERA yours?
Do patient names match your records?
Are dates of service correct?

Verify payments:

Do payment amounts seem reasonable?
Are adjustment codes appropriate?
Any denials that need attention?

Step 5: Post to PMS

Apply the ERA to patient accounts.

Auto-posting: If your PMS supports ERA auto-posting, import the 835 file and let the system match to patients and procedures.

Manual posting: If posting manually, work through each patient on the ERA, applying payments and adjustments to the correct dates of service.

Verification: After posting, verify total payments posted match the ERA total.

Understanding Cigna ERA Contents

Payment Summary Section

The ERA header includes:

Payment date
Payment amount
Trace number (for EFT) or check number
Payer information

Claim Detail Section

For each claim paid:

Patient name and ID
Subscriber information
Date of service
Claim number
Procedure codes
Amounts billed, allowed, paid, and adjusted

Adjustment Reason Codes

Cigna uses standard HIPAA adjustment reason codes.

Common codes you will see:

CO-45: Charge exceeds fee schedule/maximum allowable

This is the standard contractual adjustment
Normal for in-network claims

PR-1: Deductible amount

Patient responsibility toward annual deductible

PR-2: Coinsurance amount

Patient's percentage responsibility after deductible

PR-3: Copay amount

Flat copay if applicable to plan

CO-50: Non-covered service

Procedure not covered under patient's plan

CO-97: Payment adjusted - already paid

Duplicate claim or overlap with prior payment

CO-4: Code inconsistent with modifier

Coding issue, may need correction and resubmission

Remark Codes

Cigna may include remark codes providing additional explanation.

Common remarks:

N130: Frequency limitation exceeded
N362: Missing or invalid prior authorization
M15: Separately billed services included in basic benefit

Remark codes help explain why payment differs from expectation.

Common Cigna Reconciliation Issues

ERA Total Does Not Match Deposit

The most common problem: ERA shows $8,500 but deposit is $8,432.17.

Possible causes:

Multiple ERAs combined: Two or more ERAs may be in a single deposit. Search for additional ERAs from the same date.

Take-back included: A previous overpayment is being recouped. Look for negative amounts on the ERA.

Timing difference: A small timing adjustment between ERA generation and payment release.

Investigation steps:

Search for additional ERAs around same date
Look for negative line items on the ERA
Contact Cigna if discrepancy remains unexplained

Cannot Find ERA for Deposit

Deposit exists in bank but no matching ERA.

Check these sources:

Clearinghouse - may be in queue awaiting download
Cigna portal - search by amount and date range
Paper EOB - may have been mailed instead
Wrong practice - verify deposit is actually yours

If truly missing:

Contact Cigna provider services
Provide trace number from bank
Request ERA reissuance

ERA Shows Payment, No Deposit Received

ERA indicates payment was made but bank shows nothing.

Possible causes:

EFT information on file is incorrect
Payment sent to old bank account
Payment is in process (timing)

Investigation:

Verify EFT enrollment and bank information in Cigna portal
Check all practice bank accounts
Wait 2-3 business days for processing
Contact Cigna if payment does not appear

Denied Claims on ERA

Claims showing $0 payment with denial codes.

For each denial:

Review the denial reason code
Determine if claim can be corrected and resubmitted
Decide if appeal is appropriate
Update patient responsibility if applicable

Common Cigna denial reasons:

Missing prior authorization
Frequency limitation exceeded
Not a covered benefit
Coordination of benefits issue

Take-Backs and Recoupments

Cigna recoups prior overpayments by deducting from current payments.

On the ERA: Shows as negative payment amount with explanation.

What to do:

Find the original payment being reversed
Verify the take-back is valid
Adjust the original posting
Bill patient if they now owe
Appeal if take-back is unjustified

Time limits: Cigna typically has contractual limits on how far back they can recoup. Review your contract if you receive old take-backs.

Cigna-Specific Tips

Fee Schedule Verification

Cigna contracts with specific fee schedules. Verify you are being paid correctly.

How to check:

Compare allowed amounts to your contracted fee schedule
Look for systematic underpayment on specific codes
Contact your Cigna representative if you find discrepancies

PPO vs DPPO vs Dental HMO

Cigna offers multiple product types. Payment processes may differ.

PPO/DPPO: Standard claims and payment process.

Dental HMO (DHMO): Different payment model, often capitation-based. Reconciliation approach differs.

Verify which Cigna products you are contracted with and understand the payment mechanics for each.

Provider Advocate

If you have persistent issues with Cigna, consider contacting a provider advocate.

When to escalate:

Systematic payment issues
Contract interpretation disputes
Repeated claim processing errors

ERA Enrollment Verification

Periodically verify your ERA enrollment is active.