Get Cigna Prior Authorization Form
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How to fill out the Cigna Prior Authorization Form online
Completing the Cigna Prior Authorization Form online can streamline the process of obtaining necessary medication. This guide provides clear instructions to help users navigate each section efficiently and ensure all required information is included.
Follow the steps to complete the form accurately.
- Click ‘Get Form’ button to obtain the form and open it in your editing interface.
- Begin by filling in the provider information. Include the provider's name, specialty, DEA or TIN, office contact person, and office phone and fax numbers.
- Next, provide detailed patient information. Include the patient’s name, date of birth, Cigna ID, and contact details. Ensure that the patient’s street address, city, state, and zip code are correctly entered.
- State whether the fax machine at the office is kept in a secure location and whether a response can be faxed to the office.
- Select the medication requested, which in this case is (). Specify the dose and quantity along with the proposed duration of therapy.
- Indicate where the medication will be obtained from, such as Cigna Tel-Drug, the prescriber’s office stock, or another pharmacy. Also specify the diagnosis related to the medication request.
- Complete the disease-related questions regarding rheumatoid arthritis. Answer whether the patient has a positive clinical response to therapy, and indicate any previous medications that were not effective.
- For rheumatoid arthritis, check all applicable methods used to measure disease progression prior to therapy with .
- If applicable, provide information regarding the patient’s response to TNF antagonists and any relevant metrics supporting continued therapy.
- Include any additional pertinent information that may assist in the review process.
- Finally, review all entered information for accuracy. Save changes, download, print, or share the form as needed.
Start filling out your Cigna Prior Authorization Form online today to ensure timely processing of your medication request.
The time it takes to complete prior authorization varies depending on several factors. Generally, it can take a few days after submitting the Cigna Prior Authorization Form. To minimize delays, ensure you include comprehensive details and supporting documents. You can also check in with your healthcare provider for updates on the approval status.
Fill Cigna Prior Authorization Form
If you are unable to use ePAs, you can call us at 1 to submit a prior authorization request. Please provide the following details for each trial: manufacturer name, date(s) taken and for how long, and what the documented. Cigna has partnered with CoverMyMeds to offer electronic prior authorization (ePA) services. Select the appropriate Cigna form to get started. Required clinical information - Please provide all relevant clinical information to support a prior authorization or step therapy exception request review. Jun 19, 2025Download the Cigna Prior Authorization Form PDF for 2025. You can submit an online prior authorization request for any customer who has Cigna prescription coverage. Prior Authorizations will be given for medically necessary services only: it is not a guarantee of payment. Manage your Cigna Healthspring Prior Authorization Requests. Cigna's online prior authorization tool.
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