Pre-Notification & Emergencies

Pre-Notification for Hospitalization and Other Services

If you use an out-of-network provider in the PPOs, you must call Cigna’s Customer Service Department at 1-800-842-4211 or Anthem BlueCross and BlueShield’s Medical Management Unit at the number on the back of your ID card before receiving certain services. If you do not make this call, there is a non-notification penalty of $500.

Services for which you are required to notify your administrator in advance include:

  • hospitalization
  • home health care
  • skilled nursing facility confinement
  • hospice care
  • organ transplants

If you receive any of the above services from an in-network physician or at an in-network facility, you are encouraged, but not required, to notify administrators in advance. There is no non-notification penalty when you receive the above services in-network.

If you are unsure whether advance notification is required for a particular service, call the member services number on the back of your ID card.

In an Emergency

In a true emergency situation, visit the nearest Emergency Room for care. Your services will be covered at the in-network rate, regardless of whether you use an in-network or out-of-network hospital. Emergency Room care for non-emergency situations is not a covered expense.

If you are admitted to the hospital from the Emergency Room, you or your doctor must call Cigna’s Customer Service Department or Anthem BlueCross and BlueShield’s Medical Management Unit and notify them of your admission within 48 hours. If you are unable to call, someone else can call for you.