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HR Home >> Benefits >> Health & Dental >> Mental Health and Substance Abuse

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HEALTH & DENTAL BENEFITS

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Out-of-Network Claims
CIGNA Fill out the Out-of-Network Claim Form and mail it to:

Cigna Behavioral Health
PO Box 46270
Eden Prairie, MN 55344

Claims must be submitted within 180 days of date of service.

CIGNA Personal Assistance Service (PAS) is Duke's employee assistance program. The staff of licensed professionals offer assessment, short-term counseling, and referrals to help resolve a range of personal, work, and family problems. PAS services are available free of charge to Duke faculty and staff, and their immediate family members.
Ask the Expert: PAS

Mental Health and Substance Abuse Benefits

Duke offers both outpatient and inpatient mental health and substance abuse benefits under each of our health plans. Mental health and substance abuse benefits are administered through CIGNA Behavioral Health.

For more information, please see the Mental Health and Substance Abuse Benefits Plan Description (PDF).

Mental Health Providers

To find a network provider, call CIGNA Behavioral Health toll-free at 1-888-253-8552 or log on to their web site (Employer ID: Duke, PIN: employee). You can also browse a list of Duke mental health providers that are considered network providers for Duke employees and their dependents

Plan Chart

Details about these benefits are outlined in the chart below:

Duke Select (HMO)

Duke Basic (HMO) Duke Options (Blue Cross Blue Shield PPO) Blue Care (Blue Cross Blue Shield HMO)

 

CIGNA Behavioral Health

In-Network

Out-of-Network

Outpatient

Covered in full after $35 co-pay per visit for individual/ family therapy

$100 annual deductible
You pay 50% UCR1,4 costs

  Limit of 20 unmanaged1,2 visits per calendar year Limit of 20 visits per calendar year2
  Precertification required for psychological testing, electroshock therapy, hypnosis Precertification required for psychological testing, electroshock therapy, hypnosis
  Lab and outpatient charges and ECT, you pay 20%4 Lab and outpatient charges and ECT, you pay 50% after deductible1,4

Inpatient

You pay 20% after $250 annual deductible

You pay 50% of UCR1,4 after $250 per admission co-pay

  $1,000 annual out-of-pocket maximum Alternative care limited to non-residential programs
  Limit of 30 days per calendar year Limit of 20 days per calendar year3
  Must be precertified prior to admission Must be precertified prior to admission
  1. "Unmanaged" means that no precertification is required. However, precertification is required for psychological testing, electroconvulsive therapy (ECT), and hypnosis.

  2. The limit of 20 visits for outpatient in-network and out-of-network benefits is combined.

  3. The limits for inpatient in-network and out-of-network benefits are combined and not mutually exclusive.

  4. All payments are based on the usual, customary, and reasonable (UCR) allowable charge. You are liable for charges over UCR when receiving out-of-network services. For a definition of UCR, see the glossary.

 

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