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Cigna recredentialing 2026

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The document is a Dentist Recredentialing Application submitted to Cigna by Edith C. Van der Graaff, a general dentist. It includes personal and office information, licensing details, professional liability coverage, and responses to disclosure questions regarding the dentist's qualifications and any past disciplinary actions. The application emphasizes compliance with dental record guidelines and certifies that the information provided is accurate.

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Click ‘Get Form’ to open the Cigna Recredentialing application in the editor.
Begin by filling out the 'Personal and Office Information' section. Ensure you complete all required fields marked with an asterisk, such as your specialty, title, last name, first name, and NPI number.
Proceed to enter your dental license number and DEA information. Make sure to include expiration dates where applicable.
In the 'Disclosure Questions' section, answer each question truthfully. If you answer 'Yes' to any question, be prepared to provide detailed explanations in the space provided.
Review the 'Dental Record Guidelines' carefully and confirm your agreement by checking the certification box at the end of the document.
Finally, e-sign the document using our platform's e-signature feature and submit it for processing.

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