So you’ve gotten your first patient with a Cigna EAP. Here’s a guide to help you through the process.
EAP is a sort of pre-authorization. You can’t just see a patient and bill it to the EAP. Either the patient or the employer has to reach out to the EAP coordination system set up for them. They can specify a provider or the system can find one for them.
Then both you and the patient are sent a letter with the authorization code. Some EAP programs like Aetna have a portal where you can go in and get the letter before it actually arrives in the mail. There isn’t a portal for Cigna, so the only way to verify that the patient has a valid EAP code call their EAP folks. (If they failed to get the code or lost it, the EAP folks can look it up with the insurance information).
With Cigna, you can also request EAP sessions on behalf of the patient. You (the provider) can do it (1 (877) 622-4327) or your staff can do it if you give them the general reason the patient is looking for treatment. To get paid to see them under EAP, you have to have the authorization before the session happens.
They will get a number of sessions on a specific topic. Those sessions should be billed under 99404. Once the sessions are finished, you can refer the patient to yourself or another therapist for further treatment and bill their regular insurance under the usual codes.