Managing Evernorth Behavioral Care Group new client requests

Evernorth Behavioral Care Group is a care group that is in-network with Cigna. Cigna members seeking care through their health plan can request appointments from Evernorth Behavioral Care Group clinicians. Eligible existing Cigna clients can also be transferred into Evernorth Behavioral Care Group so future appointments follow the same policies, procedures, and billing workflow.

If you’re accepted into Evernorth Behavioral Care Group, you can use SimplePractice to manage key workflows, from receiving new client appointment requests to completing documentation and billing.

In this guide, we’ll cover:

• How Evernorth Behavioral Care Group works in SimplePractice
• Onboarding with Evernorth Behavioral Care Group 
• Managing Evernorth Behavioral Care Group new client appointment availability
• Receiving and managing appointment requests
• Using measurement-based care
• Adding progress notes
• Billing workflows for Evernorth Behavioral Care Group clients
• FAQs

How Evernorth Behavioral Care Group works in SimplePractice

When you participate in Evernorth Behavioral Care Group, you can manage key workflows directly in SimplePractice. The following provides an overview of the process, from onboarding and setting your availability to completing documentation, billing, and receiving payment.

1. Onboard with Evernorth Behavioral Care Group
   Complete the Evernorth Behavioral Care Group credentialing and enrollment process.
2. Set your new client appointment availability
   Once activated, you can manage your availability in SimplePractice. Your availability is shared with eligible Cigna members through the Cigna insurance member directory and the Evernorth Behavioral Care Group website, where they can request appointments based on your availability.
3. Prepare for your appointment
   Required scored measures will be automatically sent to clients before their appointment and throughout treatment as part of the care group’s measurement-based care requirements. Appointments are also subject to the Evernorth Behavioral Care Group cancellation policy.
4. Complete your appointment documentation within 14 days
   After each appointment, complete, sign, and lock the associated progress note within 14 days of the appointment end time. A diagnosis code is required before the progress note can be signed and locked.
5. Billing and claims are processed automatically
   Once your progress note is signed and locked, SimplePractice automatically generates an invoice for billing. If the invoice doesn't contain any errors, the information is used to automatically create and submit a claim on your behalf. If there are invoice errors, you'll receive notifications in SimplePractice prompting you to resolve them before processing can continue.
6. Meet the 14-day submission deadline
   Claims submitted after the 14-day deadline will be rejected. Correcting or resubmitting information won't restart or extend the original submission window.
7. Receive payment
   Evernorth Behavioral Care Group handles claims processing and charges clients directly for any applicable copays or out-of-pocket costs. Therapists are paid semi-monthly for completed sessions. Payment notifications come on the 1st and 16th of each month. If the 1st or 16th falls on a weekend or a company holiday, your payment will be processed on the last business day before that date.

Onboarding with Evernorth Behavioral Care Group

To participate in Evernorth Behavioral Care Group referrals, clinicians must:

• Complete the Evernorth Behavioral Care Group credentialing and enrollment process through their provider portal
• Be fully licensed
• Have up-to-date license and NPI information in their SimplePractice account
• Have a published Therapy Finder profile
• Enable online appointment requests for new clients

Your information in SimplePractice should match the information associated with your credentialing profile.

During the enrollment process, clinicians will need to:

• Complete enrollment and qualification questions
• Review and accept contract terms and rate information
• Submit credentialing documentation

Once you’ve been accepted and your enrollment is complete, Evernorth Behavioral Care Group new client requests and billing workflows will become available to you in SimplePractice.

During the enrollment process, you can track your status in Marketing > In-Network Referrals:

You can track your enrollment progress in the Status column.

Once your enrollment is Active, you can begin receiving appointment requests.

Note: Clinicians who begin enrollment but don’t complete the process may continue to appear as In review until the enrollment flow is completed or reset.

If you're currently a member of Evernorth Behavioral Care Group and need assistance with enrollment, billing, payments, or other program-related questions, visit their provider portal to access support resources and contact their support team.

If you're interested in participating, contact SimplePractice support.

Managing Evernorth Behavioral Care Group new client appointment availability

Once you’re onboarded with Evernorth Behavioral Care Group, your availability allows Cigna members to see when you're available for services and submit appointment requests through the myCigna directory.

To update your availability to receive appointment requests, follow the steps in Managing in-network referral availability and requests.

Receiving and managing appointment requests

When you receive appointment requests from Evernorth Behavioral Care Group, you can navigate to the Requests page to accept or decline the request. You can also send intake documents to the client through the Requests page.

To learn more, see Managing in-network referral appointment requests.

The initial appointment for an Evernorth Behavioral Care Group client will default to the 90791 service code. After accepting the request, you can update the appointment’s service code, if needed. Providers are expected to review and select the appropriate service code for each appointment. 

Note: Clients in-network with Cigna through Evernorth Behavioral Care Group will appear with a $0 client balance in SimplePractice. Clients pay Evernorth Behavioral Care Group directly for any applicable copays or out-of-pocket costs, and clinicians are paid through Wingspan, Evernorth Behavioral Care Group’s payment platform.

If you need to update the status of an appointment, see What is Evernorth Behavioral Care Group’s cancellation policy?

Using measurement-based care

Evernorth Behavioral Care Group requires certain scored measures throughout treatment. To support these requirements, SimplePractice automatically sends the required measures to Evernorth Behavioral Care Group clients at the frequencies below:

When clients complete scored measures, the results will appear on the Measures tab of the client’s profile.

These measures are sent automatically throughout treatment based on Evernorth Behavioral Care Group’s care quality standards and can’t be turned off.

To learn more about scored measures, see Using scored measures.

Adding progress notes

Progress notes for Evernorth Behavioral Care Group clients must be completed, signed, and locked within 14 days of the appointment end time. To add a progress note, see Creating a progress note. 

If required information is missing, such as a diagnosis code or client information, SimplePractice will display an error and prevent the note from being signed and locked until the issue is resolved. 

For example, if a diagnosis code hasn’t been added, you’ll see a message indicating that a diagnosis code is required before the progress note can be signed and locked. 

Select the link in the error message to navigate directly to the missing information. 

Billing workflows for Evernorth Behavioral Care Group clients

Evernorth Behavioral Care Group clients follow a different billing workflow than standard insurance claims in SimplePractice.

After each appointment, you’re required to complete, sign, and lock the associated progress note within 14 days of the appointment or a claim won’t be generated.

Once your progress note is signed and locked:

• SimplePractice automatically generates an invoice for billing
• The invoice is used to create and submit a claim through the Evernorth Behavioral Care Group billing workflow
  • The invoice is only used for claim processing and isn't shared with the client
• You don't need to manually create or submit claims

Note: Appointments for Evernorth Behavioral Care Group clients appear as Self-Pay in SimplePractice to help prevent claims from being manually created and submitted.

If the invoice contains missing or invalid information, you'll receive an error notification prompting you to resolve the issue before billing can continue.

Resolving invoice errors

If an invoice contains missing or invalid information, the invoice will be rejected. Invoice error notifications appear:

• On the client profile
• On the appointment page
• In your Notifications feed
• By email

If multiple appointments have invoice errors, each affected appointment will appear grouped by appointment date and time within the error notification banner.

To resolve an invoice error:

1. Review the error message displayed in the banner on the client profile or within the appointment details
   • Errors are typically caused by:
     • Missing diagnosis codes
     • Missing client/billing information
     • Invalid or mismatched claim details
2. Update missing or incorrect information
3. Save, sign, and lock the progress note again, if needed

Once the issue is resolved, the error notification will automatically be removed.

Note: You can temporarily dismiss an invoice error notification by clicking X. If the issue hasn’t been resolved, the notification will reappear until the error is corrected.

Best practices for billing

To make sure your claim is submitted successfully, complete, sign, and lock your progress note within 14 days of the appointment end time. Once your progress note is signed and locked, SimplePractice automatically generates an invoice that's used to create and submit your claim.

We also recommend that you:

• Complete, sign, and lock progress notes shortly after each appointment
• Review invoice error notifications promptly
• Resolve missing billing information as soon as possible

Important: Progress notes must be completed, signed, and locked within the 14-day submission window so the invoice can be processed for claim submission. If the invoice isn't successfully processed within this window, the claim will be rejected. Resolving invoice errors won't restart or extend the original 14-day submission window. 

If you have questions about Evernorth Behavioral Care Group's billing or provider payment requirements, contact support through their provider portal.

FAQs

• What is Evernorth Behavioral Care Group‘s cancellation policy?
• Can I stop receiving Evernorth Behavioral Care Group new client appointment requests?

What is Evernorth Behavioral Care Group‘s cancellation policy?

Appointments for Evernorth Behavioral Care Group clients follow their cancellation policy, which may differ from your practice's standard cancellation policy.

When you update the appointment’s status in SimplePractice, you’ll see guidance to help you select the status that aligns with the policy based on when the cancellation occurs.

This guidance doesn't prevent you from selecting another status. However, claims will be rejected if the correct appointment status isn’t selected according to the guidance above.

To learn more about updating an appointment’s status, see Changing an appointment’s status.

Can I stop receiving Evernorth Behavioral Care Group new client appointment requests?

Yes. You can manage new client availability from Marketing > In-Network Referrals. 

When new client appointment requests are turned off for Evernorth Behavioral Care Group, your availability will no longer appear in their provider directory, and you won’t receive new client appointment requests.

To learn more, see Turning in-network referral requests on or off.