The company also announced that network providers
who treat mental health and substance abuse problems will
no longer need to prepare outpatient treatment reviews
before getting further authorization of their patients’
benefits, according to a Hartford Courant report.
Instead, CIGNA said it will focus its cost control
efforts on more complex behavioral health problems – for
instance, outpatient treatment involving more than two
therapy sessions a week.
However, CIGNA will still require prior approval of benefits along with treatment reviews for inpatient and residential care.
The company says it has programmed its claims systems to automatically highlight complex outpatient or inpatient treatment cases, such as patients with eating disorders, emotional problems of children and adolescents, or patients needing help with prescribed treatment critical to their care. For example, a clinically depressed patient may need a reminder to fill an anti-depressant prescription, CIGNA pointed out.
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