Who they are
Networks
The tiering is the negotiation-relevant fact: “in network with Cigna” can mean either tier, at materially different allowables. Know which tier each contract signs you into before modeling revenue.
Enrollment and credentialing
- Credentialing runs through Cigna’s standard process, leaning on CAQH for provider data. Cigna states 30–60 days average processing for a complete file (carrier-claimed; plan on the long end).3 See Set up CAQH.
- DSO channel: Cigna maintains a dedicated credentialing solution for dental support organizations, described in its DSO credentialing brochure; a group adding dentists at volume should ask for that channel rather than filing one-off applications.3
- DHMO participation is contracted separately from DPPO.
Billing notes
- Standard 837D/ADA claim form workflow; confirm the current dental payer ID with your clearinghouse.
- DPPO network-access obligations are documented per state in filed network access plans (example: West Virginia DPPO network access plan).2
- DHMO compensation mechanics (capitation rosters, supplemental payments) differ entirely from DPPO fee-for-service; reconcile them separately in your PMS.
Sources
- Mordor Intelligence, US dental insurance market (secondary; names the consistently cited majors).
- Cigna, dental PPO plans; WV DPPO network access plan.
- Cigna, credentialing; DSO credentialing solutions brochure.