We are committed to helping your patients with Evernorth^® Behavioral Health (Evernorth) coverage get the care they need – when they need it. To support timely access, we have established standards for both phone responsiveness and appointment availability. We monitor our performance throughout the year and report results annually. Below are the 2025 results.  

Prior authorization

Evernorth does not require prior authorization for:

• Emergency evaluation and stabilization services.
• Routine outpatient care with providers.

Phone access (to live person)

Customers and referring providers may call Evernorth for help obtaining behavioral care appointments with an in-network provider. In 2025, Evernorth continued to respond to calls using a centrally managed, national call-answering team. To improve staff availability, we used separate phone lines for health care providers/facilities and for customers.

Customer telephone access. We work to connect customers with a live person as quickly as possible so they can find and begin care without delay. In 2025, we introduced process and staffing improvements – addressing workloads and training, streamlining hiring and back-filling, and consolidating phone queues. We also expanded digital options for submitting partial and inpatient hospitalization requests, which helped reduce call volume. The 2025 results are shown below.

Provider phone access.  We aim to connect referring providers with a live person quickly to support timely referrals to in-network behavioral health providers. Our 2025 results are shown below.

To strengthen these measures and continue meeting the needs of customers and in-network providers, we regularly review call volumes and staffing and make adjustments as needed. During periods of high call volume, team leadership also helps cover phone queues.

Appointment access (timelines)

Evernorth’s appointment-access standards reflect the urgency of a customer’s perceived need and align with industry standards. Each year, we conduct a satisfaction survey with all customers who accessed care to evaluate our performance across each category. The 2025 results are shown below.

Steps we are taking to improve access to care

To help improve access to care, we are taking the following steps:

• Implementing action plans to address those measures that were reduced or did not meet the goal.
• Continuing a directory accuracy project to validate accurate information for in-network providers and facilities.
• Continuing expansion of telehealth services to the network.
• Continuing addition of ancillary and virtual programs to the network.
• Continuing implementation of the Evernorth Care Group.

Additional information

Questions or feedback?

Please call Provider Services at 800.926.2273.