CIGNA Behavioral Health Practitioner Connection

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Contact us:

450 N Brand Blvd
Suite 500
Glendale, CA 91203
Telephone: 1-800-866-6534, ext 2742
Fax: (860) 847-5207

Send us an email:
Josue.Arguello@CIGNA.com

The Practitioner Conection
Volume XXX, 2nd Quarter

The right help at the right time!

NEW MIXED SERVICES PROTOCOL

CIGNA utilizes a Mixed Services Protocol (MSP) to assist in determining if a claim should be processed by CIGNA HealthCare (CHC) or CIGNA Behavioral Health (CBH). A new MSP for claims administration went into effect on April 15, 2009. The new MSP only applies when CIGNA provides both the medical and behavioral health benefit coverage for the participant. Please note that the changes described in this article do not apply if CIGNA is not the medical carrier for your patient. In response to the feedback that CIGNA received from practitioners and participants about claims processing, one of the goals of the updated MSP is improved practitioner and participant satisfaction with the claims process. We hope to achieve improved satisfaction through a more simplified approach to determining if CHC or CBH is responsible for processing a claim. Please find information about how the new MSP might impact you and helpful tips about submitting claims to CIGNA below:

• If you provide Neuropsychological testing, all claims should now be directed to CIGNA HealthCare for payment. CHC does not typically require prior authorization for Neuropsychological testing, but always call to confirm benefits.
• If you submit claims for Health & Behavior Assessments, using CPT codes 96150-96155, all claims should now be directed to CIGNA HealthCare for payment. CHC does not typically require prior authorization for these codes, but always call to confirm benefits.
• All other services administered by a CIGNA Behavioral Health contracted provider should be submitted using the following mailing addresses:
    o For EAP claims, PO Box 46790; Eden Prairie, MN 55344
    o For HMO claims, PO Box 46270; Eden Prairie, MN 55344 or online at www.cignabehavioral.com
    o For PPO or OAP Claims, please check the back of the member’s CIGNA card.

If you encounter any difficulty with claims processing, please contact the Provider Advocate team. Please call the number on the back of your patient’s card and follow the prompts for providers. The Provider Advocate team will work with you to resolve your concern.

If you have any questions about the information in this article, please follow the prompts for providers and request to speak with your Provider Relations Representative.