FAQ: Behavioral Health Providers

Article | March 2018

Behavioral Health Providers

Frequently asked questions about behavioral health providers

Do you have questions about Cigna's behavioral health program? We've got answers.

What types of health professionals are included in Cigna's behavioral health network?

Ph.D./MS Level: These are therapists who use talk therapy. They help you assess the issues you're facing and find solutions. They include psychologists (LP), family therapists (LMFT, LMC), social workers (LCSW, LSW), nurse practitioners (ARNP, APRN), and clinicians (LMHC). All therapists contracted by Cigna are licensed and offer treatment through independent practices. Many therapists are even starting to use video to provide more convenient access to care. And therapists' specialties are identified by Cigna as part of the credentialing process.

MD/DO/NP Level: MD's and DO's are doctors who specialize in Psychiatry or Addiction Medicine. They can diagnose problems and treat them through talk therapy. They can also prescribe medication if necessary. Many psychiatrists also have subspecialties. These include Children and Adolescents, Geriatric, Addiction Medicine, etc. All MD's and DO's contracted by Cigna are licensed and offer treatment through their independent practices.

Behavioral health providers' abbreviations can be confusing. Here's a breakdown of their types of degrees and licensure.

Types of Degrees

MSW

Masters Social Work

MS

Master of Science

MA

Master of Arts

RN

Registered Nurse

PHD

Doctorate of Philosophy - Psychology

PSYD

Doctorate of Psychology

EDD

Doctorate of Education

ARPN

Advanced Registered Nurse Practitioner

MD

Doctor of Medicine - Psychiatry

DO

Doctor of Osteopathy - Psychiatry

Types of Licensure

LISCW

Licensed Clinical Social Worker

LCSW

Licensed Clinical Social Worker

CCDC

Certified Chemical Dependency Counselor

LMFT

Licensed Marriage and Family Therapist

LCP

Licensed Clinical Psychologist

LP

Licensed Psychologist

LPC

Licensed Professional Counselor

MD

Doctor of Medicine - Psychiatry

DO

Doctor of Osteopathy - Psychiatry

Many states have different names for licensures; these are usually master's level counselors. Some of the abbreviations include: CCSW, LPCC, CADC, CCSW, LCPC, CCPC, CICSW, CPC, MFCC, LMHC, CMFT, and CMHC.

To find a list of in-network providers, please call the toll-free number on your ID card or search our Provider Directory.

What kind of behavioral treatment happens in a hospital setting?

A hospital can specialize in behavioral health treatment. A behavioral program typically takes place at a hospital or clinic. These services often include:

  • Detoxification, inpatient, and residential treatment
  • Partial hospitalization
  • Intensive outpatient programs
  • Emergency assessments
  • Other specialized, higher level of care treatments

If you're having a crisis, please go to the nearest emergency room right away. Your plan benefits will apply to services needed to evaluate or stabilize you. IMPORTANT: Most plans require pre-authorization for hospital care or behavioral programs. Please call the number on your ID card for more information.

What is a clinic?

A clinic is a practice where multiple professionals work together. Sometimes they provide complementary services. These are services that work together toward the same goal. Some behavioral health clinics only have therapists on staff. Others provide a team of therapists, psychologists, and psychiatrists.

Note: Some clinics require patients to receive care only from their professionals. And note that not all providers in a clinic may be contracted with Cigna. When choosing a clinic, ask to be referred to provider in your Cigna plan’s network.

How do you define confidentiality? Who has access to my personal information?

Information on mental health or substance use disorder treatment served by Cigna is confidential. It won't be disclosed to anyone, with the following exceptions:

  • Cigna will communicate with your treating therapist/psychiatrist about your diagnosis, symptoms, treatment goals, and treatment plan in the process of administering behavioral health benefits or EAP services.
  • When an appropriately written release of information document is completed with your signature that instructs Cigna to disclose your specific information to the person named.
  • With your written approval, Cigna will give the name of your treating therapist/psychiatrist to your primary care provider. And Cigna will give the name of your primary care provider to your treating therapist/psychiatrist. This is done as a courtesy to encourage coordination of care. You can expect your primary care provider and/or your treating therapist/psychiatrist to ask you to sign a written consent to release information. This consent allows disclosure of specific details about your behavioral health and/or medical care.
  • Mandatory reporting is required when someone is in immediate danger of hurting themselves or others.
  • As otherwise allowed or required by law.
  • To your health plan or plan sponsor for purposes of plan administration.

Note: If you're a Cigna customer, you don't have access to information about the care received by another person on your plan who is not your legal responsibility. A parent or legal guardian can access information about the benefit utilization and services provided to his/her child without being on the plan, unless court documentation is provided to Cigna saying that the parent has no legal rights to such information about his/her child.

What does "medical necessity" mean?

Medical necessity is a term used by providers. It refers to how Cigna will work with your provider to find the right level of care and length of treatment to decrease your symptoms. You and your provider will build a plan with specific behaviors and goals. When you achieve these, treatment is no longer necessary.

What if things aren't working out with my behavioral health professional?

If your behavioral health provider is no longer available or you're not making progress, you may need to switch. You can call the toll-free number on your ID card. Tell us what isn't working with your behavioral health professional. We will be happy to help you find another one.

Can I call and talk to a 'live' person if I have questions?

Use Cigna’s Health Information LineSM to talk one-on-one with a nurse. Available 24/7/365 you’ll get guidance and information on anything from urgent clinical needs to Work/Life issues. Also, if you have a Cigna employee assistance program (EAP) call us first at (877) 622-4327. This way you'll get full access to your benefits and the help of our Personal Advocates.

What do I do if I have questions about my claim?

If you have a behavioral health claim question, you can call Cigna Customer Service at the number on your ID card. However, some accounts through employers have a dedicated Customer Service/Claim line. You should dial that number for answers to your questions if your benefit plan is set up this way.

How soon should I expect an appointment?

Care should be available to you in a timely way. These timeframes for getting an appointment have been shared with our network providers. If you can't get an appointment within these timeframes, call Cigna at the number on your ID card for assistance.

Type of Care Needed: Time from Request for Care:

Non-life threatening emergency

Within 6 hours

Urgent

Within 48 hours

Routine

Within 10 working days

Office wait times

15 minutes or less

If you need emergency services, please go to the nearest ER or behavioral health facility right away. 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.

Behavioral Health Providers

This material is provided by Cigna for informational/educational purposes only. It is not medical/clinical advice. Only a health care provider can make a diagnosis or recommend a treatment plan. For more information about your behavioral health benefits, you can call the member services or behavioral health telephone number listed on your health care ID card.