Get Cigna Multiple Sclerosis Psc Prior Authorization Form 2020
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How to fill out the Cigna Multiple Sclerosis PSC Prior Authorization Form online
Filling out the Cigna Multiple Sclerosis PSC Prior Authorization Form online is a crucial step in ensuring that patients receive the necessary treatment for their condition. This guide provides helpful, step-by-step instructions to assist users in accurately completing the form.
Follow the steps to successfully complete the authorization form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Start by filling in the physician information. This section includes the physician's name, specialty, and their DEA, NPI, or TIN number. Ensure that all required fields, marked with an asterisk (*), are completed for proper processing.
- Next, enter the patient information. This will include the patient's name, date of birth, Cigna ID, contact information, and their address. Double-check to ensure accuracy to avoid any delays.
- Specify the urgency of the request by checking either 'Standard' or 'Urgent'. If you select 'Urgent', confirm that the request meets the criteria for urgency.
- Indicate the medication requested for the patient and fill in the required details such as dose and quantity, duration of therapy, and frequency of administration.
- Provide important information regarding whether this is a new start or continuation of therapy. If it is a continuation, specify the current status of the patient's treatment.
- Complete the section detailing where the medication will be obtained, along with the facility or doctor administering the medication, including their address and tax ID number.
- Fill in the diagnosis section by selecting the appropriate diagnosis that applies to the patient.
- Answer the clinical information questions based on the patient's current treatment and any previous drug responses or intolerances.
- Complete the attestation and sign the form, ensuring all information provided is accurate to the best of your knowledge.
- After completing the form, save your changes. You have the option to download, print, or share the completed form as needed for submission.
Submit your completed documents online to expedite the authorization process.
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authorization, often referred to as prior authorization, works by requiring you or your healthcare provider to obtain approval from your insurance company before proceeding with specific treatments or prescriptions. This ensures that the services are deemed necessary and covered under your plan. With the Cigna Multiple Sclerosis PSC Prior Authorization Form, your provider submits the request to Cigna, who reviews it against their guidelines. It is important to follow up and provide any additional information they may request to avoid delays.
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