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(Medical Indication) PRESCRIPTION & ENROLLMENT FORM Four simple steps to submit your referral. 4 PRESCRIBING INFORMATION 1 PATIENT INFORMATION Patients name Date of birth Male.

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About Accredo As part of your Cigna-administered pharmacy benefits, you have access to Accredo, a Cigna specialty pharmacy.

Accredo provides specialty drugs, drugs that cost more than $600 per month, with the average being $10,000 a month, which treat serious conditions such as multiple sclerosis, rheumatoid arthritis, hemophilia and cancer. It is a wholly owned subsidiary of Express Scripts and is headquartered in Memphis.

Express Scripts' prior authorization phone lines are open 24 hours a day, seven days a week, so a determination can be made right away. If the information provided meets your plan's requirements, you pay the plan's copayment at the pharmacy.

You can: Submit new requests for prior authorization. Check on the status of submitted requests. Submit an authorization renewal or appeal on a previously submitted request.

Accredo is a specialty pharmacy that serves patients with complex and chronic health conditions, including cancer, hepatitis C, HIV, bleeding disorders and multiple sclerosis. We understand the complexity of these conditions and treatments.

Both CVS and Express Scripts own specialty pharmacies of their own — CVS Specialty and Accredo — which are the nation's largest. These pharmacies mainly handle complex drugs that need to be injected or refrigerated, and they often provide support, like call centers staffed with nurses, to assist patients.

Accredo is a specialty pharmacy that serves patients with complex and chronic health conditions, including cancer, hepatitis C, HIV, bleeding disorders and multiple sclerosis. We understand the complexity of these conditions and treatments.

Accredo®, part of Express Scripts, is now Cigna's preferred specialty pharmacy. Cigna Specialty Pharmacy no longer fills prescriptions. > Your patients have been informed of this change and may request a new prescription from you.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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