Clinical Review Outlines
As a Healthcare Professional in the Cigna Behavioral Health, Inc. network serving managed care patients, you will be asked to participate in Cigna's clinical review process. You can help expedite this process by reviewing in advance Cigna's Medical Necessity Criteria for admission, continued stay, and discharge. Please note that you may be asked to provide a range of information within a clinical review, depending on your patient's diagnosis and the level of care at which he/she is being treated. The outlines below, based on diagnosis and level of care, may be used by Cigna care managers to gather information during the clinical review process.
Initial Higher Level of Care Review Outline
General Higher Level of Care Concurrent Review Outline
CA Higher Level of Care Concurrent Review Outline
SA Higher Level of Care Concurrent Review Outline
Eating Disorder Higher Level of Care Concurrent Review Outline
MH IOP Concurrent Review Outline
SA IOP Concurrent Review Outline
Eating Disorder IOP Concurrent Review Outline
Outpatient Review Outline
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