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Cigna to Drop Emdeon EDI Exclusivity

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Cigna Healthcare has announced it will end its five-year exclusive claims clearinghouse contract with Emdeon Business Services on Jan. 1, 2010.

Under the arrangement, Nashville, Tenn.-based Emdeon was the only clearinghouse that could submit electronic claims to Bloomfield, Conn.-based Cigna. Other clearinghouses would have to route their Cigna claims through Emdeon, getting a much lower transaction fee in the process.

Cigna said the change in policy to accept claims from other clearinghouses is an effort to better serve provider organizations. Cigna in the announcement named Ingenix as a clearinghouse from which it will accept claims and said it would announce additional clearinghouse connections in 2010.

The insurer will continue to have an exclusive relationship with Emdeon, "with limited exceptions," for dental transactions.

Since 2004, Cigna has accepted and will continue to accept claims and related transactions that providers directly submit to the insurer through an encrypted Internet connection from Post-N-Track Corp., Wethersfield, Conn.

--Joseph Goedert

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A major success factor for accountable care organizations will be linking caregivers across the spectrum of care delivery. If history is any indication, that's going to be an industrywide struggle.

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