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Network
Providers
Medical & Mental Health for 2009
The provider network for 2009 is CIGNA Open Access Plus. The PPO applies to all medical & mental health service providers, including durable medical equipment, lab work, and other ancillary providers. If you are registered at www.mycigna.com , that is the best place to search for a provider. You can also call CIGNA at 1-800-244-6224 for assistance, or you may use the web site and instructions below.
- At www.cigna.com
, under Locate Resources For Members, click on "Provider Directory"
- What Type of Provider - select Physician, Hospital, or Facility/Ancillary
- Provider's Name - leave blank to find all, or enter the last name only
- Tip: Enter only the first two or three letters of the last name, or no name, to get the broadest search. This will help you in case there are any spelling errors.
- Where to Look - enter City and State, or Zip - leave address blank
- Click Next
- What Type of Plan You Have - select Open Access Plus ONLY
- What Are You Looking For - select the type of provider or leave as All
- Tip: If you are looking for an OB/GYN, use the listing under Specialist instead of Primary Care.
- Click Search
A health care provider may add or cancel participation in the network at any time. Please verify your provider's status prior to receiving services. If your doctor is not currently part of the CIGNA Open Access Plus network, but would like to receive information about joining, please have him or her complete this nomination form , and return it directly to CIGNA to begin the process.
If you use a physician or facility not on the list, any
reimbursement will be at the non-PPO level, and you may have
to pay any charges that exceed the maximum reimbursable charge.
NOTICE: Although health care services may be provided to you at a health care facility that is a member of the provider network used by this Plan, other professional services may be provided at or through the facility by physicians and other health care practitioners who are not members of the network. You may be responsible for payment of all or part of the fees for those professional services that are not paid or covered by this Plan.
Anesthesiologists at a PPO hospital should be paid as if they were a PPO provider. However, you may have to pay any charges that exceed the maximum reimbursable charge.
Pre-certification (or prior authorization) is required for an in-patient hospital admission (10 days before
scheduled admission, by 36th week of pregnancy, or within 48 hours
of urgent admission), in-patient treatment at a skilled nursing facility or rehab hospital, non-emergency ambulance, and transplant services. Pre-certification is also required for all mental health and substance abuse services which are inpatient, residential, partial hospitalization, and intensive outpatient programs. These types of services involve treatment at a facility. Pre-certification is not required for routine outpatient services, which is normally treatment with an individual provider.
Medical & Mental Health for 2010
These services will be provided through TRS-ActiveCare, administered by Blue Cross Blue Shield of Texas.
Dental Plans for 2009
Both dental plans have access to the CIGNA Dental PPO - CORE Network . You may use a non-CIGNA dentist, but you will pay more for their services. All claims will be paid according to the negotiated PPO rates.
- At www.cigna.com
, under Locate Resources For Members, click on "Provider Directory"
- What Type of Provider - select Dentist
- Provider's Name - leave blank to find all, or enter the last name only
- Tip: Enter only the first two or three letters of the last name, or no name, to get the broadest search. This will help you in case there are any spelling errors.
- Where to Look - enter City and State, or Zip - leave address blank
- Click Next
- What Type of Plan You Have - select CIGNA Dental PPO - CORE Network
- What Are You Looking For - select the type of provider or leave as All
- Click Search
Dental Plans for 2010
Both dental plans will have access to the Delta PPO and Delta Premier networks. The PPO network will provide a greater price discount on services than the Premier network, but dentists in both networks will file your claims for you and will not bill you for amounts that exceed the Delta network approved cost.
You can search both the PPO and the Premier networks at www.deltadentalins.com.
Vision Plans for 2009 & 2010
Vision Service Plan (VSP) has a national
network of optometrists .
You can also reach VSP by calling 1-800-877-7195.
If you use a provider not on the list, any reimbursement will be
at the out-of-network rate.
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