August 2025

In case you missed them, here is a recap of and links to all of the behavioral health articles that were published in the Provider Newsroom in August.

Latest news for Evernorth Behavioral Health providers

(August 27, 2025) Wondering what’s been added since your last visit to the Provider Newsroom? Access a summary of the latest news by month.

Updated Evernorth Behavioral Health Administrative Guidelines now available

(August 22, 2025) The Evernorth Behavioral Administrative Guidelines for in-network providers, clinics, and facilities include program requirements, policies, rules, and procedures for providing behavioral health services to patients with Evernorth or Cigna Healthcare coverage.

ACA annual risk-adjustment outreach supports equal access to care for your patients

(August 13, 2025) As part of the Affordable Care Act (ACA), Cigna Healthcare Individual & Family Plans must comply with the ACA risk-adjustment program. Providers that receive a request to submit one or more patient medical records as part of a risk-adjustment request or a risk-adjustment data validation audit are required to respond.

New network option supports Cigna Healthcare Garden State plan

(August 13, 2025) Effective July 1, 2025, a new network option, the Open Access Plus New Jersey Network, supports customers with Cigna Healthcare Garden State plan coverage. These customers are required to use in-network providers with service locations in the state of New Jersey only.

The importance of alerting us to expedited appeals that need immediate attention

(August 6, 2025) Timely access to necessary medical services can be paramount to achieving optimal patient outcomes. Your proactive intervention in escalating expedited appeals filed by your patient can be critical when they have an urgent medical condition that requires a decision be made quickly.

Expedited appeal submission tips

(August 6, 2025) When you have an urgent need to appeal a coverage denial or partial coverage denial, and receive a decision very quickly to speed the start of treatment, you may be able to request an expedited appeal if services have not been performed and meet certain criteria.