How to Get Credentialed with Cigna

Overview of Cigna's Provider Networks

Cigna is a major national health insurer providing coverage to millions of members through employer-sponsored plans, individual plans, Medicare Advantage, and government programs. In recent years, Cigna Group restructured its operations, with Evernorth Health Services serving as the health services arm that includes behavioral health, pharmacy benefits, and care delivery.

For mental health professionals, understanding this structure matters because behavioral health credentialing may involve interaction with different Cigna and Evernorth entities depending on the specific product and geographic region. In most cases, outpatient behavioral health providers apply through Cigna's standard credentialing process, but certain plan types or regions may have behavioral health managed through Evernorth-affiliated services.

Cigna maintains provider networks for a range of behavioral health services, including individual and group psychotherapy, psychological testing, medication management, substance use treatment, and higher levels of care. As a therapist or counselor, you will typically be credentialed into the outpatient behavioral health segment of Cigna's network.

Verify directly with Cigna. Cigna's credentialing requirements, processes, and timelines are subject to change. The information in this guide is for general reference only. Always confirm current requirements by contacting Cigna's Provider Services line or visiting the Cigna provider portal before beginning your application. Do not make business decisions based solely on third-party information.

Before You Apply

Ensure you have the following documents and information prepared before starting your Cigna credentialing application:

• Active, unrestricted professional license in the state where you intend to provide services
• National Provider Identifier (NPI) — your Type 1 individual NPI is required, and a Type 2 organizational NPI if you operate a group practice
• Fully completed and attested CAQH ProView profile with Cigna authorized to access your data
• Professional liability (malpractice) insurance with coverage limits that meet or exceed Cigna's requirements
• Tax Identification Number — SSN for sole proprietors or EIN for group practices and other business structures
• Complete work history covering at least the past five years, with explanations for any gaps
• Education and training records including your graduate degree, supervised clinical hours, and any post-doctoral training
• Board certifications if applicable to your discipline
• DEA certificate if applicable to your scope of practice

Having all documents current and readily available before you begin will prevent the most common delays in the process.

Setting Up CAQH for Cigna

Cigna requires a complete CAQH ProView profile as the foundation of your credentialing application. If you already have a CAQH profile from credentialing with other payers, you will not need to create a new one, but you do need to ensure it is current and that Cigna is authorized to access it.

Key CAQH preparation steps

1. Register or log in to CAQH ProView at proview.caqh.org. If registering for the first time, you will receive a CAQH provider ID number that you will use throughout the credentialing process.
2. Review and complete every section of your profile. Cigna pulls data directly from CAQH, so any blank fields or missing information will trigger a request for additional information and delay your application.
3. Upload all supporting documents. This includes your current license, malpractice insurance declarations page, W-9, DEA certificate (if applicable), and any board certification documents.
4. Authorize Cigna to access your data. Navigate to the health plan authorization section of your CAQH profile and confirm that Cigna is listed and authorized. Without this authorization, Cigna's credentialing team cannot retrieve your information.
5. Attest your profile. CAQH requires re-attestation every 120 days. Verify that your attestation is current before initiating your Cigna application.

The Application Process

Step 1: Check network availability

Before investing time in the application, contact Cigna's provider relations or recruitment team to ask whether they are accepting new behavioral health providers in your area and for your license type. In some markets, Cigna may be actively recruiting; in others, the panel may be restricted.

Step 2: Initiate your application

You can typically start the process through the Cigna provider portal or by contacting Cigna's Provider Relations department. Cigna will use your CAQH data as the primary information source. Some applicants are directed to fill out a brief supplemental form in addition to the CAQH data pull.

Step 3: Primary source verification

Cigna's credentialing team will conduct primary source verification, independently confirming your professional license, education, training, malpractice claims history, work history, and any disciplinary actions. This involves contacting licensing boards, educational institutions, malpractice carriers, and other relevant organizations directly.

Step 4: Credentialing committee review

Once verification is complete, your file goes to a credentialing committee for formal review and a decision. The committee evaluates your qualifications based on the verified information and Cigna's network criteria.

Step 5: Contract execution

If the credentialing committee approves your application, Cigna will issue a provider agreement for your review and signature. Read the contract thoroughly before signing. Pay close attention to the fee schedule, timely filing requirements, billing procedures, termination provisions, and any behavioral health-specific clauses.

Step 6: Effective date and directory listing

Your effective date as an in-network Cigna provider is typically determined by the date the contract is fully executed. After activation, verify that your information appears correctly in Cigna's online provider directory.

Behavioral Health-Specific Considerations

Cigna's behavioral health credentialing includes several considerations that are specific to mental health and substance use treatment providers:

Scope of practice verification

Cigna verifies not only that you hold a valid license but also that the services you intend to bill fall within your scope of practice as defined by your state licensing board. Make sure your CAQH profile accurately reflects the services you provide.

Specialty designations

When completing your application, specify your clinical specialties accurately. Cigna's provider directory categorizes behavioral health providers by specialty (e.g., anxiety, depression, trauma, substance use, child and adolescent), and accurate specialty designations help members find appropriate providers.

Telehealth credentialing

Cigna has expanded telehealth coverage significantly. If you plan to provide telehealth services, confirm with Cigna whether any additional credentialing steps or attestations are required for telehealth-delivered services in your state.

Medication-assisted treatment

If you provide medication-assisted treatment for substance use disorders (e.g., buprenorphine prescribing), there may be additional credentialing requirements related to your DEA registration and specific waivers.

Typical Timeline

The Cigna credentialing process typically takes 90 to 120 days, following this general pattern:

• Weeks 1-2: Application submission and completeness screening
• Weeks 2-4: CAQH data retrieval and initial documentation review
• Weeks 4-10: Primary source verification of credentials, license, education, malpractice history, and work history
• Weeks 10-14: Credentialing committee review and decision
• Weeks 14-16: Contract issuance, execution, and provider system loading

Delays most commonly occur during the primary source verification phase, particularly if licensing boards or educational institutions are slow to respond, or if your CAQH profile was missing information that Cigna needs.

Common Pitfalls

Incomplete CAQH profile

As with most major payers, the number one cause of Cigna credentialing delays is an incomplete CAQH profile. Missing documents, expired attestation, or blank fields will stall your application before it even enters the verification phase.

Not authorizing Cigna in CAQH

Your CAQH profile may be complete and attested, but if you have not explicitly authorized Cigna to access your data, they cannot proceed. Double-check your CAQH health plan authorizations.

Expired malpractice insurance or license

If your professional license or malpractice coverage expires during the credentialing process, Cigna will pause your application until updated documentation is provided. Monitor expiration dates and renew proactively.

Inaccurate specialty or service information

Listing services or specialties that fall outside your licensed scope of practice can result in application delays or denials. Be accurate and honest about your qualifications and the services you intend to provide.

Failing to follow up

Cigna handles a large volume of credentialing applications. Without regular follow-up, your application may sit in a queue longer than necessary. Contact Cigna's provider relations team every two to three weeks to check status and ask whether any additional information is needed.

Re-Credentialing with Cigna

Cigna requires re-credentialing on a regular cycle, typically every three years. The re-credentialing process mirrors the initial credentialing process — Cigna pulls your updated CAQH data, re-verifies your credentials, and the credentialing committee reviews your file.

To prepare for smooth re-credentialing:

• Keep your CAQH profile updated year-round. Update your profile whenever your license is renewed, your malpractice insurance changes, you add or change a practice location, or any other professional information changes.
• Re-attest your CAQH profile every 120 days to maintain an active profile status.
• Watch for re-credentialing notifications from Cigna and respond promptly. Missing the re-credentialing window can result in involuntary termination from the network.
• Maintain continuous malpractice coverage. Any lapse in coverage will complicate re-credentialing.

Tips for Success

• Start early. With a 90 to 120 day timeline, begin the credentialing process well before you anticipate needing to see Cigna patients.
• Keep meticulous records. Document every interaction with Cigna's credentialing team, including dates, names, reference numbers, and what was discussed.
• Use the Cigna provider portal. Register for access to Cigna's online provider tools as soon as possible. The portal allows you to check application status, manage your profile, submit claims, and access other resources.
• Understand the Evernorth relationship. If you receive communications from Evernorth-related entities during the credentialing process, do not disregard them. They may be part of the standard Cigna credentialing workflow for behavioral health providers.
• Verify your directory listing after credentialing. Once active, search for yourself in Cigna's provider directory to confirm that your name, credentials, specialties, address, phone number, and other details are correct. Inaccurate directory listings can prevent potential clients from finding you.