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Cigna makes it easy for health care providers to submit claims, with EDI vendors and easy clean claim requirements. Member Claim Form. Insured and/or Administered by. Connecticut General Life Insurance Company. CIGNA Behavioral Health, Inc.If my provider participates in Cigna Behavioral Health's network, The payment authorization box at the bottom of the claim form dictates to whom. Log in to your individuals and families customer area · Review your policy documents · Access claim forms · Find hospitals, physicians, clinics and health and Health Care Claim Forms · Medical Forms · Dental Forms · Pharmacy Forms · Vision Forms · Behavioral Forms · Accidental Injury, Critical Illness, Hospital Care and NOTE: Cigna may disclose the information on this form to other persons and entities, MAILING INSTRUCTIONS FOR CIGNA BEHAVIORAL HEALTH CLAIMS:. Download and print a ready-to-use claim form. · Mail your completed claim form(s), with original itemized bill(s) attached, to the Cigna HealthCare Claims Office Cigna Health and Life Insurance Company. Cigna Behavioral Health, Inc. Cigna HealthCare*. RETIRED*. EMPLOYED. AT THE TIME MEDICAL SERVICE WAS PROVIDED WAS Follow these instructions for filing medical, dental, mental health, and supplemental health claims. Download and print the claim form; Complete and mail Complete only if claim is for a dependent and/or other coverage is in effect. NOTE: X. NAME OF HEALTH INSURANCE COMPANY. EFFECTIVE DATE OF COVERAGE.