Mental Health/Substance Abuse

Features & Benefits

Caring for the Whole Member

With CIGNA's behavioral health and substance abuse services, we evaluate every individual's personal situation - from their current condition to their ideal health status - in order to tailor our care to meet each person's specific needs.

Through our long-established Care Advocacy program, we have developed several principles to which we firmly adhere. Those include addressing the "whole person," using data to determine which participants can benefit most from targeted assistance and developing a collaborative relationship with providers and facilities to ensure cost effective, quality care. It is the foundation of our behavioral programs and services and the value that we offer to you.

We tailor an individual's care based on his or her condition, available benefits and medical necessity. This comprehensive approach ensures appropriate utilization, cost management, and the highest quality participant care while avoiding administrative barriers.

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How it Works

Our Care Advocacy Philosophy

At CIGNA, Care Advocacy is the underlying philosophy of our behavioral health and substance abuse services. Care Advocacy means that we interact with every individual as if he or she is the only one.

We are committed to molding our response, guidance or intervention to each member's unique needs, and we determine how he or she can benefit most from assistance.

Individuals benefit from our policy of no preauthorization for routine outpatient care, clinical identification of at-risk individuals and coordination of care from our behavioral specialists.

For those individuals who qualify for coverage of inpatient care, a care manager reviews the participant's condition and treatment plan in detail and provides assistance with discharge planning. We also follow a traditional utilization review process, while adding advocacy and targeted interventions that reinforce the importance of treatment goals and after-discharge care.

Individuals at high risk for an inpatient admission are invited to participate in intensive care management, which helps the individual find additional resources that may be helpful in the treatment process.

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Employer Advantages

At CIGNA we believe that when our customer's employees are healthy, the customer's business is healthy. To achieve this we offer:

• Industry leading integration of behavioral, medical, and lost productivity management
• Proactive Intervention based on early risk identification
• Effective member engagement through intrinsic coaching
• Utilization and cost management to provide effective care that is efficient and appropriate

But most of all, our programs offer to you our Care Advocacy philosophy developed over years of experience. It's the foundation of our business and the way we add value to yours.

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