When to use this playbook
- You are opening a medical or behavioral health practice and want to serve patients with Cigna Healthcare coverage.
- You are an LCSW, LPC, LMFT, or psychologist unsure whether to apply to Cigna Healthcare or Evernorth Behavioral Health.
- Your organization includes both medical and behavioral clinicians and needs to route each provider correctly.
- Your application has been pending long enough that you need a concrete status and escalation process.
What success looks like
Success means the correct legal entity has approved the provider, the participation agreement covers the intended TIN and locations, and the practice has a written effective date. An application, completed credentialing review, or signed contract is not enough by itself; the provider must be loaded for the correct network before the practice treats claims as in-network.
The naming is easier once the contracting relationship is separated from the patient’s insurance card. Cigna Behavioral Health became Evernorth Behavioral Health on September 1, 2021. A behavioral provider can therefore contract with Evernorth while treating patients whose ID cards and benefit plans carry the Cigna Healthcare name.
Step 1: Choose the correct contracting path
Action: Route the application by service type, referral model, and practice structure before creating an account or submitting forms.
| Provider or organization | Primary path | Starting point |
|---|---|---|
| Physician, medical specialist, or medical facility | Cigna Healthcare medical network | Call Cigna Provider Services at 1-800-882-4462 and select the credentialing option. |
| Independently licensed LCSW, LPC, LMFT, or psychologist in private practice | Evernorth Behavioral Health individual-provider contract | Complete the Provider Information Form through the Evernorth Provider Portal. |
| Behavioral group with fewer than four independently licensed clinicians | Evernorth individual-provider process | Apply for each clinician through the provider portal. |
| Behavioral clinic with four or more independently licensed clinicians sharing a TIN, location, and administrative staff | Evernorth clinic contract | Complete the Behavioral Health Clinic Screening Application. |
| Behavioral clinician working only inside a participating Cigna medical practice, without direct community referrals | The existing Cigna medical contract may be the applicable route | Call 1-800-882-4462 before submitting an Evernorth application. |
| Behavioral clinician accepting community referrals or practicing outside the participating medical practice | Evernorth Behavioral Health | Apply through the Evernorth Provider Portal. |
Expected outcome: Every provider has one clearly assigned application path, contracting entity, TIN, and service-location list.
Gotcha: A Cigna ID card does not mean an independently practicing therapist should use the Cigna medical application. The behavioral contract is usually with Evernorth.
Time estimate: This routing decision should be completed before document collection and usually takes less than a day when the referral and practice structure are clear.
Step 2: Make the credentialing file application-ready
Action: Reconcile the provider’s CAQH profile, licenses, insurance, work history, TIN, W-9, locations, and specialties before initiating either path.
| File component | Cigna medical | Evernorth behavioral |
|---|---|---|
| Professional license | Valid and unrestricted in the applicable practice state. | Must permit independent practice without supervision. |
| CAQH | Complete or re-attested, with Cigna authorized to access the profile. | Current CAQH ID and authorization for Evernorth; re-attestation is generally required every 120 days and every 180 days for Illinois providers. |
| Work history | Previous five years, with explanations for gaps longer than six months. | Five consecutive years, with explanations for gaps longer than six months. |
| Liability coverage | Coverage meeting state and specialty requirements; Cigna recommends $1 million per occurrence and $3 million aggregate for medical applicants. | Generally $1 million per occurrence and $1 million aggregate for non-prescribing clinicians, subject to listed state exceptions. |
| Prescribing credentials | Current DEA and state CDS credentials or the applicable Cigna documentation when the provider does not hold them. | Current DEA credentials for prescribing providers and applicable service locations. |
| Entity information | Provider and group identifiers, practice addresses, specialties, and the information requested in the application packet. | A W-9 for each TIN; the W-9 and CAQH tax information must match the Provider Information Form. |
Expected outcome: The application can be completed without waiting for a provider to reconstruct employment dates, replace an expired insurance certificate, or correct conflicting tax information.
Gotchas: The most damaging errors are mismatched TINs and W-9s, stale CAQH attestations, missing service locations, and unexplained work-history gaps. For Evernorth, a provisional or associate-level license does not satisfy the independent-licensure requirement for an individual contract.
Time estimate: A current, accurate CAQH profile can make this a same-day review. Missing licenses, insurance documents, or provider signatures can extend preparation by days or weeks.
Step 3: Start and submit the correct application
Cigna medical application
Action: Call Cigna Healthcare Provider Services at 1-800-882-4462, select credentialing, and complete the pre-application screening. If the provider meets the basic guidelines, Cigna sends an application packet by email. Complete the packet, authorize Cigna to access CAQH, and return every requested attachment.
Expected outcome: Cigna confirms receipt of a complete medical credentialing packet and begins verification.
Gotcha: Do not assume that creating a Cigna for Health Care Professionals account replaces the pre-application call. Cigna’s current first-time medical instructions begin with Provider Services. Missing information can lead to file closure rather than an indefinite pending status.
Time estimate: Cigna can often determine basic application eligibility during the initial call. Credentialing typically takes 45–60 days after receipt of the application packet, followed by up to 10 business days to load an approved provider into directories and claims systems. Review Cigna’s medical credentialing process.
Evernorth individual-provider application
Action: Register for the Evernorth Provider Portal, obtain contracting access, select “Contracting” under “My Practice,” and complete the Evernorth Behavioral Health Provider Information Form.
Expected outcome: The provider receives application tracking and notifications through the portal.
Gotcha: The application must be finished in one session; it cannot be saved and resumed. Prepare the CAQH ID, W-9, locations, insurance information, work history, and licensing data before starting.
Time estimate: Evernorth allows up to 90 calendar days for the contracting and credentialing process.
Evernorth clinic application
Action: A clinic with four or more independently licensed behavioral clinicians sharing a TIN, location, and administrative staff completes the Behavioral Health Clinic Screening Application and sends the application and supporting documents to BehavioralOutpatientClinic@Evernorth.com.
Expected outcome: The Evernorth clinic contracting unit reviews the submission and provides next steps or requests additional information.
Gotcha: A group name or Type 2 NPI does not automatically make a practice an Evernorth clinic. Groups below the four-clinician threshold use the individual-provider path. Review Evernorth’s individual and clinic definitions.
Step 4: Manage the application as an active work queue
Action: Record the submission date, confirmation number, TIN, NPI, contracting entity, service locations, last payer contact, outstanding request, and next follow-up date. Recheck CAQH authorization whenever an application stops moving.
- Cigna medical status: Email PSSCentral@Cigna.com with the provider’s full name and TIN, or call 1-800-882-4462 and select credentialing.
- Evernorth behavioral status: Check the application through the provider portal. Questions can also be directed to BehavioralProviderRecruitment@Evernorth.com or 1-800-926-2273; include the NPI or TIN.
Expected outcome: The payer identifies the application’s current stage, any missing item, who owns the next action, and whether the published review period has been exceeded.
Gotcha: “Pending” is not a useful status. Ask whether the file is in intake, primary-source verification, credentialing committee review, contracting, or claims-system loading. These stages have different owners and remedies.
Time estimate: A Cigna medical file exceeding 60 days or an Evernorth file approaching or exceeding 90 days warrants a documented status request. A four-month delay should be escalated immediately rather than left in a routine follow-up cycle.
Step 5: Confirm the effective date before billing as in-network
Action: Obtain the written approval and effective date, verify the approved TIN and locations, confirm the provider appears in the correct directory, and test eligibility under an applicable patient plan before treating the enrollment as operational.
Expected outcome: The billing team knows the first date of service that can be submitted under the in-network arrangement and which entity governs the contract.
Gotchas: Do not infer an effective date from the submission date, credentialing committee approval, or contract signature. Evernorth can grant provisional credentialing in limited cases, but the practice should rely on it only when the provider receives explicit confirmation. Behavioral claims and remittances can reference both Cigna and Evernorth because the patient may have a Cigna health plan while the provider’s behavioral contract is with Evernorth. Evernorth’s provider FAQ explains the two names.
Time estimate: Cigna medical loading can take up to 10 business days after approval. Build that final loading period into opening dates, scheduling, and revenue forecasts.
Where Arctic Health fits
Arctic Health is most useful when an organization has mixed medical and behavioral providers, multiple TINs or locations, no dedicated payer-operations team, or applications that require sustained follow-up. The work is not merely form completion: each Cigna medical and Evernorth behavioral file must remain attached to the correct provider, contract, location, and effective date.
Arctic Health gathers and verifies documentation, manages CAQH, submits complete payer applications within two business days, tracks payer responses, handles rejections, and follows each file through completion. Its published average for the broader credentialing process is 60–90 days; the payer’s own review clock still controls the final decision. Arctic Health’s credentialing process provides the operating details.
A solo provider with a clean CAQH profile and time to monitor the portal can reasonably run a single Evernorth application directly. Arctic Health becomes the more practical option when a founder, RCM director, or compliance team needs one owner for the application, contract, follow-up, activation, and ongoing maintenance.
Frequently asked questions
As an LCSW, LPC, LMFT, or psychologist, am I contracting with Cigna or Evernorth?
Most independently licensed LCSWs, LPCs, LMFTs, and psychologists contract with Evernorth Behavioral Health, even when their patients carry Cigna Healthcare insurance cards. Evernorth is the behavioral network formerly called Cigna Behavioral Health. The main exception involves behavioral clinicians working exclusively inside a participating Cigna medical practice without accepting direct community referrals; those clinicians should call Cigna before applying. Evernorth’s contracting instructions set out this distinction.
Do all behavioral clinicians use the same Evernorth application?
Independently licensed behavioral clinicians use the individual-provider process unless the organization qualifies for Evernorth’s clinic pathway. Evernorth treats a practice as a clinic when four or more independently licensed behavioral providers share the same TIN, location, and administrative staff. Smaller groups apply through the individual-provider workflow for each clinician rather than submitting the clinic screening application.
How long before opening should I start Cigna or Evernorth credentialing?
Start 90–120 days before a fixed opening date. Cigna publishes a 45–60-day medical credentialing period after receiving a complete packet and allows up to 10 additional business days for system loading. Evernorth allows up to 90 calendar days for behavioral contracting and credentialing. The larger planning window leaves time for CAQH corrections, provider signatures, missing documents, contracting, and billing setup. Cigna’s published timeline identifies the medical review and loading periods.
Can I bill Cigna patients before credentialing is approved?
Do not bill or represent services as in-network until the provider has a written effective date. Evernorth can grant provisional credentialing in limited circumstances, but provisional status must be explicitly approved; it should never be inferred from a submitted application. If care begins earlier, verify the patient’s benefits and determine the applicable out-of-network or self-pay arrangement before the visit rather than assuming the payer will retroactively apply in-network rates.
My application has been pending for four months. What can I actually do?
Request a specific stage, missing-item list, owner, and next action immediately. For Cigna medical applications, contact PSSCentral@Cigna.com or call 1-800-882-4462 with the provider’s full name and TIN. For Evernorth, check the provider portal and contact BehavioralProviderRecruitment@Evernorth.com with the NPI or TIN. Also confirm that CAQH remains attested, the correct payer is authorized, and no information request was routed to an outdated email address.