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Prior Authorization
How to request precertifications and prior authorizations for patients.
Depending on a patient's plan, you may be required to request a prior authorization or precertification for any number of prescriptions or services. A full list of CPT codes are available on the CignaforHCP portal .
For Medical Services
- Description of service
- Start date of service
- End date of service
- Service code if available (HCPCS/CPT)
For Pharmacy Services
To better serve our providers, business partners, and patients, the Cigna Healthcare SM Coverage Review Department is transitioning from PromptPA, fax, and phone coverage reviews (also called prior authorizations) to Electronic Prior Authorizations (ePAs). ePAs save time and help patients receive their medications faster. Moving forward, please use one of the following portals below.
If you are unable to use electronic prior authorization, you can call us at 1 (800) 882-4462 to submit a prior authorization request.
Choose a Prior Authorization Portal to Get Started
Evicore ® by evernorth.
Conveniently manage your medical and pharmacy drug prior authorization with EviCore by Evernorth.
For both oncology pharmacy drug and medical prior authorization for Cigna Healthcare patients, please choose the option for Medical Oncology Pathways. For other pharmacy drug prior authorization for Cigna Healthcare patients, please choose the option for Pharmacy Drugs (Express Scripts ® Coverage).
Learn more about EviCore by Evernorth
Surescripts ®
Connect to all Pharmacy Benefit Manages (PBMs) and payers with ePA from Surescripts. We can help you easily submit ePA requests and save you valuable time if you haven’t fully integrated ePA into your EHR workflow.
Learn more about Surescripts
CoverMyMeds ®
CoverMyMeds is a one-stop solution that works for all medications and all payers.
Learn more about CoverMyMeds
Related Documents
- Arkansas Prior Authorization Exemption Legislation FAQs
- Indiana Prior Authorization Form [PDF]
- MA Cardiac Imaging Prior Authorization Form [PDF]
- MA CT/CTA/MRI/MRA Prior Authorization Form [PDF]
- MA PET - PET CT Prior Authorization Form [PDF]
- Massachusetts Behavioral Health Prior Authorization Form [PDF]
- Massachusetts Transcranial Magnetic Stimulation Prior Authorization Form [PDF]
- Texas Prior Authorization Exemption Legislation FAQs [PDF]
- Texas Standard Prior Authorization Request Form for Health Care Services [PDF]
- Vermont Uniform Medical Prior Authorization [PDF]
- View more prior authorization forms at CignaforHCP
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La aseguradora publica el formulario traducido para fines informativos y la versión en inglés prevalece para fines de solicitud e interpretación.
The insurer is issuing the translated form on an informational basis and the English version is controlling for the purposes of application and interpretation.
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