Evernorth Outpatient Behavioral Network Exception Request Form 2025

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On February 13, 2023, Cigna renamed its holding company The Cigna Group, its health benefits provider business unit Cigna Healthcare, and its Evernorth business unit Evernorth Health Services.
Please complete this form, save it to your computer, then email it to: NER@Evernorth.com (preferred) or fax 860-687-7329.
Evernorth Behavioral Care Group offers end-to-end services to all those covered under our partnering insurers. We provide in-network services to all members covered under Evernorth Health Services and Cigna Healthcare commercial plans.
Please complete this request with your contact details and some information about your needs. If you are a member and need help with your benefits, call (888) 736-7499.
Please provide any additional relevant information (do not attach extra pages): 6. Please complete this form, save it to your computer, then email it to: NER@Evernorth.com (preferred) or fax 860-687-7329.
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