Behavioral Health and Substance Abuse Benefits

Personal Assistance Service

Duke offers up to eight short-term counseling visits to Duke employees and their immediate family members through the Personal Assistance Service (PAS) at no cost to you. The staff of licensed professionals offer assessment, short-term counseling and referrals to help resolve a range of personal, work and family matters. For information, call (919) 416-1727.

Applied Behavior Analysis for Treatment of Autism Spectrum Disorder

Children of Duke employees covered under the Duke Options plan may seek treatment for Autism Spectrum Disorder with Applied Behavior Analysis.

Duke offers both outpatient and inpatient behavioral health and substance abuse benefits under each of our medical plans. Benefits are administered through Cigna Behavioral Health.

Cigna Behavioral Health now allows video visits for patients seeing a participating in-network provider. This will require downloading the appropriate software or app used by the provider if this type of service is desired. The co-pay is the same as an in-person visit.

For more information, please see the Summary Plan Description.

Behavioral 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. Network providers who conduct video-based visits may be found on the Cigna website by selecting "Telehealth" from the Topic Specialty drop-down list. In addition, a listing of Duke behavioral health providers that are considered network providers for Duke employees and their dependents is available here. You may also call the Duke Psychiatry and Behavioral Health Appointment Center at 919-684-0100 to find or schedule an appointment with a Duke behavioral health provider.

Out-of-Network Claims

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

Cigna Behavioral Health
Attn: Claims Service Dept.
P.O. Box 188022
Chattanooga, TN 37422

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

2020 Plan Chart

Details about behavioral health and substance abuse benefits are outlined below.

	Duke Select (HMO)	Blue Care Blue Cross NC (HMO)
	Cigna Behavioral Health
	In-Network Care	Out-of-Network Care
Outpatient	Covered in full after $20 co-pay for individual/ family therapy ($25 co-pay for Duke Basic) Precertification required for psychological testing, electroshock therapy, and hypnosis	After $650 annual deductible, per visit you pay 30%** Limit of 20 visits per calendar year for Duke Select, Duke Basic, and Blue Care participants (no visit limit applies for Duke Options) Precertification required for psychological testing, electroshock therapy, and hypnosis
Inpatient	Co-pay of $600 per admission Must be precertified prior to admission	After $900 per admission co-pay and deductible, you pay 30% Limit of 20 days per calendar year for Duke Select, Duke Basic, and Blue Care participants (no day limit applies for Duke Options) Must be precertified prior to admission For Duke Options, the deductible and co-insurance maximum will be consolidated with medical claims

**All payments are based on the allowable charge. You are responsible for charges over the allowable charge when receiving out-of-network services.

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