CBH Practitioner Conection
Volume XXIV, 4th Quarter

ANNOUNCEMENTS

Recognized for Excellence

CIGNA Behavioral Health’s (CBH) National Care Center was recently awarded full three-year accreditations for Managed Behavioral Health Organizations from the National Committee for Quality Assurance (NCQA). The accreditations cover commercial managed behavioral health products effective 10/25/07 through 10/25/10.

Full Accreditation is granted for a period of three years to those plans that have excellent programs for continuous quality improvement and meet NCQA’s rigorous standards. NCQA accreditation standards are intended to help organizations achieve the highest level of performance possible, reduce participant risk for untoward outcomes, and create an environment of continuous improvement.

CBH focuses on improving behavioral health by coordinating care, ensuring access, and providing good customer support for participants. Our mission is to provide compassionate and innovative services and unparalleled clinical expertise to our customers, participants and business associates.

As a private, non-profit organization, the NCQA is dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians and physician groups in key clinical areas and manages the evolution of HEDIS, the tool the nation's health plans use to measure and report on their performance. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices. For more information, visit www.NCQA.org.

Updating Billing Information

CIGNA Behavioral Health (CBH) returns over 400 claims back to participating practitioners/providers per week. In general, these claims are returned because the billing name, Tax Identification Number (TIN) or billing address does not match the information CBH has on file. The result of having to return claims for additional or updated information is delayed claim payment. It is possible to update demographic and TIN information on-line. Simply go to www.cignabehavioral.com and click on ‘Are you a Provider?” then click on ‘Forms and Tools’ to view the link for updating Demographic information. If your claims are submitted electronically, it is important to also ensure that the clearinghouse that is used for submission also has the correct information.

Medical Management Program

CIGNA Behavioral Health (CBH) is proud to present the revised Medical Management Program (MMP), formerly informally known as the CBH Provider Guide. The MMP has undergone several modifications in its format. The MMP is now divided into two sections: the Administrative Guide and the Provider Guide. The Administrative Guide contains information, as well as policies and procedures, on several topics, including Provider Network, Care Management, Claims, Quality Management and CBH Products. The Provider Guide section currently includes specific information for the following states: California, Maine, Massachusetts, New Hampshire, New Jersey, North Carolina, Texas, and Vermont.

The Medical Management Program is attached to the practitioner’s contract by reference. Therefore, CBH encourages all participating practitioners to become familiar with the information included in the MMP. For any questions or concerns, practitioners can contact their local Provider Education Specialist or send an email to ProviderEducation@cignabehavioral.com.

CIGNA Behavioral Health Compensation Promotes Quality of Care and Utilization Management

Compensation to health care practitioners and providers and to CIGNA Behavioral Health (CBH) staff is intended to encourage preventive care, to promote quality of care and the appropriate use of medically necessary care. CBH does not specifically reward practitioners, providers, or other individuals conducting utilization review for issuing denials of coverage for service. CBH considers quality of care, quality of service and appropriate use of medical services prior to awarding any bonuses or incentives to practitioners, providers and staff.

EAP Specialty Recruitment

Critical Incident Responders

Responding to Critical Incident events such as natural disasters, industrial accidents, bank robberies, and workplace violence is a critical function of the Employee Assistance Program (EAP). CIGNA Behavioral Health (CBH) is currently recruiting for practitioners to deliver this service to our EAP customers. Documented Critical Incident Response (CIR) training is needed to add this specialty to your profile. The following states have been identified as needing additional providers who have this specialty: AL, MS, DE, MD, DC, LA, ME, WI, and Northern CA. The following cities have also been identified as needing CIR providers: Toledo, OH; Cleveland, OH; Cincinnati, OH; Dayton, OH; Bloomington, IN; Muskegon, MI; Grand Rapids, MI; Lansing, MI; Ann Arbor, MI; Oklahoma City, OK; Reno, NV; Carson City, NV; Santa Fe, NM; Albuquerque, NM; Spokane, WA; Macon, GA; Tallahassee, FL; Panama City, FL; Laurinburg, NC; and Suffolk County, NY. E-mail ProviderEducation@cignabehavioral.com for more information.

EAP Trainers

Experienced trainers who can deliver 1 hour wellness and management training seminars are needed in Boston, MA; Rapid City, SD; New Orleans, LA; Middletown, PA; Dunmore, PA; MS; AL; and Puerto Rico. For more information email ProviderEducationSpecialist@cignabehavioral.com.

CEAP Alert

If you have obtained the Certified Employee Assistance Professional (CEAP) credential for the first time this year, please contact us at ProviderEducation@cignabehavioral.comwe can include this important information in your provider profile.

Other Featured Articles:

ASSESSING SUICIDALITY

CIGNA WINS MULTICULTURAL AWARD

FACILITATING CULTURAL AND LANGUAGE MATCH

INSURANCE IDENTIFICATION CARDS

INCREASING CBH REFERRALS

MEET THE EMPLOYEE ASSISTANT CONSULTANT TEAM

PRACTITIONER SELF INTRODUCTIONS

ONLINE COACHING PROGRAM 

HEALTH INFORMATION RATED POSITIVELY

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