CIGNA Behavioral Health will help you find the resources you need by recommending qualified network providers* in your area and processing all claims for behavioral healthcare services. In addition, members are entitled to free counseling through the Employee Assistance Program (EAP), which can be arranged by calling CIGNA Behavioral Health at 866-640-2772 or visiting their Web site.
Pre-Certification
Pre-certification is required** for:
- all facility-based treatment for either mental health or substance abuse (inpatient hospitalization, partial-day programs, intensive outpatient therapy, and services in a residential treatment facility)
- biofeedback and electroshock therapies
- all psychological testing
All emergency hospitalization services for mental health and substance dependency treatment must be pre-certified within 48 hours of admission. Benefits are payable only if pre-certification requirements are met.
CIGNA Behavioral Health does not require pre-certification for routine, non-EAP outpatient office visits with an eligible provider. To find an in-network facility, you must contact them to determine medical necessity and to pre-certify the proper level of care to help rapid claim payment at the maximum in-network level.
Please remember to use your CIGNA Behavioral Health identification card.
Find a Provider
Phone: 866-640-2772
Online:
- Go to www.cignabehavioral.com.
- Under the Members section, click on "Login to access your benefits"
- Enter our Employer ID: pcusa (in lowercase letters with no spaces)
- Click "Go"
- To find a network provider, select “Find a Provider” from the choices in the left-hand navigation.
Filing Claims
In most cases, your providers will file claims for you. If they do not, please send the claims for services to:
CIGNA Behavioral Health
P.O. Box 46270
Eden Prairie, MN 55344
* If you elect to use an out-of-network provider, benefits are paid on an out-of-network basis. If network providers are not available in your area, CIGNA Behavioral Health helps you find the care you need and benefits are paid on the network basis.
** Before claims for services without required pre-certification are considered for reimbursement, the Plan’s utilization review consultant, CIGNA Behavioral Health, determines the appropriateness and medical necessity for the services retroactively.
If the services would have been pre-certified had they been submitted as required, the claim is processed as usual, but a $200 administrative fee is applied to cover the additional cost of the post-service review. If the services do not qualify for certification as appropriate and medically necessary, no benefits are paid.