Cigna is one of the largest health insurance companies in the US. In this article you will learn how to bill Cigna for mental health claims.

Cigna has more than one panel. Even if you are a Cigna provider for some plans it does not mean you are a preferred provider for every Cigna plan. You can call Cigna directly at: (800) 926-2273.

How to Bill Cigna

First you should verify the client’s mental health benefits are managed by Cigna. Even though they have a Cigna card, it does not mean that their mental health coverage is covered by Cigna.

Call Cigna directly to inquire about the client’s mental health benefits. Call (800) 926-2273.

Follow our benefits verification script to verify your paneling status with the client’s insurance plan. If authorization is required, you can obtain it on this call.

You can also have us at TheraThink handle it for you. We handle verification and claims with Cigna daily.

Cigna Claims Address: Where To Send Cigna Claims

You can file Cigna claims electronically or via mail with this Cigna claims address:

Electronic Payer ID: 62308
Address: PO Box 182223 Chattanooga Tennessee 37422-7223
Phone Number: (800) 926-2273

What is Cigna’s Timely Filing Limit (TFL)?

The standard Timely Filing Limit for Cigna in-network providers is 90 days. Typically, claims must be submitted within 90 days from the date of service. For out of network providers the timely filing limit is 180 days. However, this can vary depending on the specific insurance plan. If this is not met, a provider can file a dispute.

Do I Need To Be In-Network In Order to Bill Cigna?

Not necessarily. Many Cigna plans are PPO plans that have both in and out of network benefits. Out of network benefits typically require the client to pay more out of pocket for services.

Call Cigna and verify the benefits to ensure that you know how the claims will be processed before seeing the client.

Cigna HMO & Cigna EPO

Cigna HMO & EPO plans you must be in-network with the client’s insurance plan for it to be covered. These plans do not offer out of network benefits.

How to Bill Cigna EAP

Cigna sells insurance plans that offer EAP (Employee Assistance Program). These plans require authorization and will only cover a set amount of visits. EAP visits do not require a co-pay. Cigna EAP claims need to be filed differently than normal Cigna claims or EAP claims from other companies.  Providers must use the CPT Code 99404.

How to Bill Cigna Telehealth

Cigna Telehealth Modifier Code is: 95.

Which CPT Codes Should I Use to Bill Cigna?

Mental Health Providers will use:

1. 90791
2. 90834
3. 90837

This is a Nightmare!

We can help you sort out these sorts of things without your input whatsoever.  Our expertise comes in handy daily when parsing out these carve out policies (in all states).  Learn how we can handle your mental health billing today.