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  • Cigna Viscosupplementation Prior Authorization Form

Get Cigna Viscosupplementation Prior Authorization Form

Medical (MED) Benefit MED Type of Review Care Management Type of Review Precertification Fax: 617-972-9409 Department to Review Pre-Cert Note: This pharmacy medical necessity guideline applies to commercial products. For Tufts Health Plan Medicare Preferred members, please refer to the Tufts Health Plan Medicare Preferred Prior Authorization Criteria. Background, applicable product and disclaimer information can be found on the last page. OVERVIEW Osteoarthritis (OA) is the most.

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How to fill out the Cigna Viscosupplementation Prior Authorization Form online

Filling out the Cigna Viscosupplementation Prior Authorization Form online can seem daunting, but with clear guidance, you can navigate through the process smoothly. This user-friendly guide will provide step-by-step instructions to help you complete the necessary fields accurately.

Follow the steps to fill out the form completely and accurately.

  1. Click the ‘Get Form’ button to access the Cigna Viscosupplementation Prior Authorization Form and open it for editing.
  2. Provide your personal information in the designated fields. This may include your name, contact details, and insurance information. Ensure that all information is accurate and up to date.
  3. Enter the details of the prescribed treatment, specifying the type of viscosupplementation you are seeking. Include information regarding the provider's recommendations.
  4. Document any previous treatments attempted for osteoarthritis, including medications or therapies used. Outline both the results and any side effects experienced.
  5. Attach supporting clinical documentation, if required. This documentation may include medical history, test results, and other relevant information that supports your request.
  6. Review the completed form for accuracy and completeness. Ensure that all necessary fields are filled out and all attachments are included.
  7. Save your changes, then choose to download or print the completed form. You may also opt to share it electronically, as necessary.

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Prior authorization (also called “preauthorization” and “precertification”) refers to a requirement by health plans for patients to obtain approval of a health care service or medication before the care is provided. This allows the plan to evaluate whether care is medically necessary and otherwise covered.

How long is the review process? A prior authorization decision may take up to 24 to 72 hours. How do I check the status of a prior authorization request?

16 Tips That Speed Up The Prior Authorization Process Create a master list of procedures that require authorizations. Document denial reasons. Sign up for payor newsletters. Stay informed of changing industry standards. Designate prior authorization responsibilities to the same staff member(s).

Beginning July 1, 2022, Cigna® commercial plan members will have access to both and GELSYN-3, to treat knee osteoarthritis (OA) pain. , is a single-injection and GELSYN-3, is a three-injection hyaluronic acid (HA)-based joint-fluid treatment for patients.

Outpatient hospital and ambulatory surgical centers require prior authorization.

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.

Typically, within 5-10 business days of receiving the prior authorization request, your insurance company will either: Approve your request. Deny your request. Ask for more information.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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