Issue: Cigna Entity Study ID

Number

0131

Submitting Entity (SE)

67369A, 67369, 67369F, 67369B, 99CIG2

Add Date

Jun 27, 2023

Update Date

Jul 14, 2023 Mar 8, 2024 May 15, 2024

Update

Included in May 2024 data tips email

Description

UPDATED.

NOTE:  This data tip has been updated several times based on validation findings and resubmitted data.  The previous data tip has been struck through, leaving the current data tip for use:

Issue:  Previously, all CIGNA entities (67369, 67369A, 67369B, 67369C, 67369D, 67369F, 99CIG2) had Study_ID issues.  All have been resolved with the exception of those for 67369A, 67369B and 99CIG2.  Study_IDs (ME998+ME013)  for these entities are incorrect and do not match Study_IDs from any other submitting entities, including CIGNA. However, there is a partial workaround:

Cigna entities 67369A, 67369B and 99CIG2 were sunsetted by Cigna between 2020 and 2021 and replaced by 67369. Approximately 75% of the data in these entities are also found in 67369.  Study_IDs for 67369 are correct. 

Many Study_IDs for 67369A, 67369B and 99CIG2 can be pulled from 67369 using a member ID (ME107) match.  Join 67369A member records to 67369 member records on ME107 and output the 67369 Study_ID for the matching 67369A member record.  The same join can be used for 67369B to 67369 and 99CIG2 to 67369.

Study_IDs for 67369A, 67369B and 99CIG2 that do not match 67369 cannot be corrected.

Member to claims matching using submitting entity ID and member ID (ME001+ME107 to MC001+MC137) is unaffected.

 

UPDATED but not completely resolved - Study ID issue

 

Study_IDs have been resolved for 67369 and 67369F.

 

Values in the APCD Unique ID (ME998) for all CIGNA entities have been found to be incorrect. While they match across CIGNA entities they do not match to other non-CIGNA entities (it is expected that between 5% and 10% should match other entities).

 

A potential workaround is to group member records on Gender (ME013), Date of Birth (ME014) or Year of Birth (ME014_Year), Member ZIP5 (ME017) or Member ZIP3 (ME017_Zip3) and Member County (ME173).  This workaround has risks when full date of birth and zip code are not available. 

 

WARNING:  Because this matching option does NOT include study ID there is a greater chance of mismatches.

Member to claims matching is unaffected.

Active/Resolved

NOT RESOLVED

Action / Resolution

 

Category 1

APCD Unique ID/Hash ID

Category 2

Data Quality

Tip / Issue

Issue