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Get Cigna Prior Auth Form For Injectable Medication
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How to fill out the Cigna Prior Auth Form For Injectable Medication online
Filling out the Cigna Prior Auth Form for Injectable Medication online can streamline the process of obtaining necessary medications. This guide provides clear and comprehensive instructions to help users complete the form accurately.
Follow the steps to successfully complete the form online.
- Click ‘Get Form’ button to obtain the form and open it in your preferred document editor.
- In the provider information section, fill in your name, specialty, DEA or TIN, office contact person, and contact information, including phone and fax numbers.
- In the patient information section, provide the patient's name, Cigna ID, date of birth, and complete address details. Confirm the security of your fax machine and whether you consent to receive responses via fax.
- Detail the medication requested by specifying the name, strength, and dosing schedule, along with the diagnosis related to its use, and the duration of therapy.
- List any formulary alternatives that were tried, including the duration of the trial and whether samples were given.
- Fill in the compound ingredient information, including the drug names, NDCs, quantities, and costs for each ingredient up to ten.
- Include any additional pertinent information that may support the authorization request, such as clinical reasons for the drug or relevant lab values.
- Once all fields are completed, review the form for accuracy, save your changes, and prepare to download, print, or share the document as needed.
Complete your forms online today for a smoother medication authorization process.
Precertification is required for specified outpatient services for any Cigna administered plan with Personal Health Solutions Plus (PHS+), Health Matters-Complete and Health Matters-Preferred medical management. ... provided by non-participating health care professional and/or facilities.
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