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  • Healthspring Prior Authorization

Get Healthspring Prior Authorization

D (*) items on this form are completed** * DEA or TIN: Office Contact Person: * Patient Name: Office Phone: * CIGNA ID: Office Fax: * Date Of Birth: * Is your fax machine kept in a secure location? * May we fax our response to your office? Yes Yes Office Street Address: City No No * Patient Street Address: City State Zip State Zip Patient Phone: Medication requested: (please specify name, strength, and dosing schedule): Diagnosis related to use: Duration of therapy: Formular.

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Private, for-profit plans often require Prior Authorization. Medicare Advantage (MA) plans also often require prior authorization to see specialists, get out-of-network care, get non-emergency hospital care, and more.

Private, for-profit plans often require Prior Authorization. Medicare Advantage (MA) plans also often require prior authorization to see specialists, get out-of-network care, get non-emergency hospital care, and more.

Cigna-HealthSpring Referral Policy Although a Prior Authorization may not be required for certain services, a REFERRAL from a PCP to a Specialist MUST BE in place. The Referral should indicate PCP approved for a consultation only or for consultation and treatment, including the number of PCP approved visits.

eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for Cigna Healthcare.

If you are unable to use electronic prior authorization, you can call us at 800.88Cigna (882.4462) to submit a prior authorization request. For Inpatient/partial hospitalization programs, call 800.926.2273. Submit the appropriate form for outpatient care precertifications. Visit the form center.

For Medical Services If you are unable to use electronic prior authorization, you can call us at 1 (800) 882-4462 to submit a prior authorization request.

The prior authorization process begins when a service prescribed by a patient's physician is not covered by their health insurance plan. Communication between the physician's office and the insurance company is necessary to handle the prior authorization.

Why does my health insurance company need a prior authorization? The prior authorization process gives your health insurance company a chance to review how necessary a medical treatment or medication may be in treating your condition. For example, some brand-name medications are very costly.

HealthSpring Life & Health Insurance Company, Inc. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Cigna-HealthSpring CarePlan is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232