On April 24, 2026, as part one of our 2025 CAQH® CORE1 recertification and in alignment with the CAQH CORE Eligibility & Benefits Data Content Rule, we enhanced our 270/271 eligibility and benefits transaction capabilities. These improvements are designed to help you verify coverage more easily and receive faster, more consistent eligibility and benefit information.
Cigna Healthcare® is a CAQH CORE-certified entity, demonstrating compliance with the administrative simplification provisions of the Affordable Care Act.
How this helps your office
Starting April 24, when you submit a 270/271 eligibility and benefits inquiry for patients with plans administered by Cigna Healthcare, you can expect:
- Benefit details that are more accurate and more specific.
- Clearer coverage information for patients aligned with a value-based care model.
- Fewer duplicate transactions, helping reduce rework and delays.
- Stronger alignment with CAQH CORE operating rules and industry standards.
Enhancement details
Here’s a more in-depth look at the 270/271 transaction capability upgrades:
- Support for all 181 CORE required Service Type Codes (STC) - for more precise benefit responses.
- Fewer STCs included in a general STC 30 (health benefit plan) request - so you receive clearer, more targeted benefit output.
- Display of number of remaining visits, services, units, etc. - This information will be returned when maximum benefit limitations apply. If the benefit has been exhausted, the next eligible date for that benefit will be returned.
- Value-based care attribution. This response may be returned for a patient based on the submitted National Provider Identifier (NPI).
What this means for your EDI vendor
We’ve shared these updates with your electronic data interchange (EDI) vendor and completed testing with them. Your vendor may have already communicated this information to you. The updated Cigna Healthcare 270/271 companion guide has been made available to your vendor.
Planned enhancements coming later this year
Future phases of our CAQH CORE recertification are expected to include these capabilities to make benefit inquiries even more actionable, including:
- The ability to request benefit information by procedure code.
- Display of the appropriate benefit tier.
More details to come!
Questions
If you have questions about how these enhancements may affect your electronic eligibility submissions or responses, please contact your EDI vendor directly for support.
