Do treatment services need to be pre-authorized?
For routine outpatient office visits with an
in network provider,
you do not need to contact us for prior authorization.
To find an in network provider use our
online directory
or our telephonic
directory by calling the number on the back of your ID card.
In all other cases you must contact us to
pre-authorize your care to help rapid claim
payment at the maximum in network level. It
is helpful to have the employee's social
security number (found on the insurance
identification card) when you call.
Be sure you understand the difference between
in-network and out-of-network coverage. Seeing a
professional who participates in CIGNA Behavioral
Health's network means you'll pay less and have
no paperwork. In addition, the professional will
be licensed and meet CIGNA
Behavioral Health's quality guidelines.
If you don't understand what is and isn't
eligible for coverage by your plan, please
contact us. We can help explain your coverage,
deductibles and copays, and tell you how to
access the kind of care you need. Also, read your
benefit plan carefully for details of your
eligible coverage.
When is psychological testing authorized?
Psychological testing is used as a diagnostic
tool to help determine the focus of your care.
Your doctor will need to contact CIGNA Behavioral
Health to discuss his/her recommendation for
psychological testing in order to establish medical
necessity . Some types of psychological
testing may not be covered by your benefit plan.
What do I do in the case of an emergency?
If you need emergency services please go to the
nearest emergency room or behavioral health
facility. We request that you or a representative
call us as soon as possible, preferably within 48
hours, so that we can help you determine the
benefits available to you under your plan. Your
plan benefits will apply to services needed to
evaluate or stabilize treatment for a condition
that is reasonably considered to be an emergency
behavioral health condition.
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