Claims and Eligibility
Standards and Requirements
The company of which Blue Cross and Blue Shield of Montana is a division and The Cigna Group entered into a definitive agreement whereby it will acquire Cigna Healthcare’s Medicare Advantage, Supplemental Benefits, Medicare Part D and CareAllies businesses. We expect the transaction to be completed in the first quarter of 2025, subject to customary closing conditions and required regulatory approvals.
Check the following FAQs when addressing provider questions about the acquisition.
Q. Are BCBSMT Medicare members’ or Cigna Healthcare Medicare Advantage customers’ plan benefits changing?
A: Members’ and customers’ plan benefits selected during the annual enrollment period for 2025 will not change in 2025.
Q: Since the annual enrollment period for 2025 will occur before the transaction is finalized, what happens to customers or members who purchase Cigna Healthcare or BCBSMT Medicare Advantage plans during 2025 annual enrollment?
A: Cigna Healthcare’s Medicare Advantage businesses and HCSC remain separate companies until the transaction is finalized. Since the transaction is expected to close in 2025, each company will operate independently and sell their respective products through the annual enrollment period from Oct. 15 through Dec. 7, 2024. People who purchase Cigna Healthcare or BCBSMT plans during open enrollment will remain enrolled in and covered by the BCBSMT or Cigna Healthcare Medicare Advantage plan they selected for the duration of the 2025 plan year.
Q: Although plan benefits remain the same, will anything else change for 2025?
A: Both companies regularly update their business processes and technology throughout the year. If these types of regular operational updates take place, we will keep you informed of any changes impacting you or your business. Please regularly read News & Updates and Blue Review for the latest news from BCBSMT. For Cigna Healthcare Medicare Advantage updates, see their provider newsroom.
Q: What will happen in 2026?
A: We will keep you posted on any changes impacting the 2026 plan year. Please regularly read News & Updates and Blue Review for the updates from BCBSMT. For Cigna Healthcare Medicare Advantage updates, see their provider newsroom.
Q: Where do I go for information about caring for these customers and members?
A: For Cigna Healthcare Medicare Advantage customers, go to the Cigna Healthcare Medicare Advantage provider website. For BCBSMT members, go to the BCBSMT website. For the latest information, please regularly read News & Updates and Blue Review for the updates from BCBSMT. For Cigna Healthcare Medicare Advantage updates, see their provider newsroom.
Q: What if I have questions about a member’s or customer’s care?
A: If you have questions, please call the number on the member’s or customer’s ID card.
Q: Whom do I call for help?
A: Provider network contacts for Cigna Healthcare Medicare Advantage and BCBSMT will remain the same for 2025. For BCBSMT contacts, see our Contact Us page. For Cigna Healthcare Medicare Advantage, contact your aligned provider relations representative or Cigna Healthcare Medicare Advantage Provider Customer Service at 800.230.6138. We will provide information about 2026 at the appropriate time.
Q: I’m a behavioral health provider contracted with Evernorth Behavioral Health and provide care to Cigna Healthcare Medicare Advantage customers. Will my network or processes change as a result of this transaction?
A: You will remain in the Evernorth network. Follow your normal processes for caring for Cigna Healthcare Medicare Advantage members.
Q: How do I know which processes to follow for Cigna Healthcare Medicare Advantage customers and BCBSMT members?
A: When providing services to Cigna Healthcare Medicare Advantage customers and BCBSMT members:
Q: Since BCBSMT Medicare business and Cigna Healthcare’s Medicare Advantage businesses will be joining together in early 2025, which medical policies, prior authorization and billing processes do I follow?
A: Following finalization of this transaction, you should not expect any changes to processes related to medical policies, prior authorization or billing processes as a result of the transaction. For BCBSMT members, follow current BCBSMT processes for providing and billing for care. For Cigna Healthcare Medicare Advantage customers, follow current Cigna Healthcare Medicare Advantage processes for providing and billing for care.
Q: Which provider manuals should I follow?
A: Follow BCBSMT provider manuals when caring for BCBSMT members. Follow Cigna Healthcare Medicare Advantage provider manuals when caring for Cigna Healthcare Medicare Advantage customers.
Q: Where do I submit claims?
A: Follow Cigna Healthcare Medicare Advantage claims submission processes for Cigna Healthcare Medicare Advantage customers and BCBSMT claims submission processes for BCBSMT members throughout 2025. We will provide you with information for 2026 at the appropriate time.
Q: Cigna Healthcare Medicare Advantage has a provider portal and BCBSMT uses Availity® Essentials. Will I need to get an Availity account?
A: Use the current Cigna Healthcare Medicare Advantage provider portal when caring for Cigna Healthcare Medicare Advantage customers, and use Availity Essentials when caring for BCBSMT members. We will provide you with information for 2026 at the appropriate time.
Q: Where will my payments come from, BCBSMT or Cigna Healthcare Medicare Advantage?
A: You will continue to bill and receive payment from each respective company as you do today.
Q: In 2025, will I be paid BCBSMT rates or Cigna Healthcare Medicare Advantage rates?
A: When caring for a BCBSMT member, you’ll receive BCBSMT contracted rates if you are in the member’s network. When caring for Cigna Healthcare Medicare Advantage customers, you’ll receive Cigna Healthcare Medicare Advantage contracted rates if you are in that network.
Q: I’m contracted with both Cigna Healthcare Medicare Advantage and BCBSMT. What do I do?
A: When caring for Cigna Healthcare Medicare Advantage customers, follow Cigna Healthcare Medicare Advantage processes. When caring for BCBSMT members, follow BCBSMT processes.
Q: I’m contracted with Cigna Healthcare Medicare Advantage but not BCBSMT. What do I do?
A: For 2025, follow your normal processes for caring for Cigna Healthcare Medicare Advantage customers. We will provide information about 2026 at the appropriate time.
Q: I’m contracted with BCBSMT but not Cigna Healthcare Medicare Advantage. What do I do?
A: For 2025, follow your normal processes for caring for BCBSMT members. We will provide information about 2026 at the appropriate time.
Q: My credentialing is due for renewal in 2025. How do I get recredentialed?
A: For 2025, follow the BCBSMT or Cigna Healthcare Medicare Advantage credentialing process as applicable. We will provide information about 2026 at the appropriate time.
