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Get Cigna Step Therapy Exception Form
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How to fill out the Cigna Step Therapy Exception Form online
This guide provides a clear and comprehensive overview of filling out the Cigna Step Therapy Exception Form online. By following these steps, users can ensure they provide all necessary information to facilitate their medication exception request.
Follow the steps to complete the Cigna Step Therapy Exception Form effectively.
- Click ‘Get Form’ button to download the Cigna Step Therapy Exception Form and access it in an editable format.
- Complete the provider information section. Include vital details such as the provider name, specialty, DEA or TIN, office contact person, and office contact numbers.
- Fill out the patient information section. Make sure to provide the patient’s full name, ID number, date of birth, and contact details, including their address and phone number.
- In the medication requested field, specify the medication's name, strength, route of administration, and dosing schedule. Be as detailed as possible to support your request.
- Provide a diagnosis related to the requested medication. Clearly state the condition that necessitates the use of this medication.
- Indicate the expected duration of therapy. This helps the reviewer understand the timeframe during which the medication will be necessary.
- List alternative medications that have been tried for the diagnosis, including the length of the trial and whether any samples were provided. This information is crucial for your request.
- Add any additional pertinent information that may support your request. Include clinical reasons for the drug choice, relevant lab values, or any other information that could assist in the decision-making process.
- Once all sections are filled, review the form for completeness. It's essential that all required fields are accurate to avoid delays in processing.
- Fax the completed form to (866)249-1172, or call (800)558-9363 for any inquiries regarding the submission. Ensure you save a copy of the form for your records.
Start completing the Cigna Step Therapy Exception Form online today to streamline your medication request process.
To request a tier exception, you usually need to complete a specific form provided by your insurance company. The Cigna Step Therapy Exception Form may serve as part of this process. Your healthcare provider can guide you through the necessary steps to ensure your request is comprehensive and meets insurance requirements.
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