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  • Pre-service Appeal Form - Cigna

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Request for Reconsideration of Medicare Denial of Medical Coverage To request a reconsideration (appeal) of a denied medical service/item not yet received, please complete the following and either.

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Call Customer Service at the number on your Cigna ID card. If customer service is unable to resolve your concern, ask the representative how to appeal. If you are not satisfied, we will provide information on other options that may be available.

If no additional documentation is required for your appeal or reconsideration request, fax in only this completed coversheet. You may use the space below to briefly describe your reason for appeal or reconsideration.

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.

There are two types of appeals: first-level appeals and second level appeals. You always start with a first-level appeal. Both are done inside within Cigna.

Find out why the health insurance claim was denied. ... Read your health insurance policy. ... Learn the deadlines for appealing your health insurance claim denial. ... Make your case. ... Write a concise appeal letter. ... If you lose, try again.

Most claim issues can be remedied quickly by providing requested information to a claim service center or contacting us. Before beginning the appeals process, please call Cigna Customer Service at 1(800) 88Cigna (882-4462) to try to resolve the issue.

Asking for an appeal is easy. This may include a claim number, a date of service and a doctor's name. Explain why you'd like us to think about our decision. Then, call Cigna Customer Service. Let them know you'd like to file an appeal.

Your appeal should be submitted within 180 days and allow 60 days for processing your appeal, unless other timelines are required by state law.

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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
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