Get Cigna Healthcare Prior Authorization Form ( Gel-one) 2020-2025

Filling out the CIGNA HealthCare Prior Authorization Form for Gel-One can seem daunting, but with this guide, you'll navigate the process effortlessly. Our step-by-step instructions will help you complete the form accurately and efficiently.

Follow the steps to complete the form correctly.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. Complete the physician information section. This includes entering the physician's name, specialty, DEA, NPI, or TIN, and the office contact person's details.
3. Next, fill out the patient information section. You'll need to provide the patient's name, Cigna ID, date of birth, address, and phone number.
4. Indicate the urgency of the request. Choose between 'Standard' or 'Urgent' based on the patient's medical needs.
5. Specify the medication requested from the list provided. Make sure to note the quantity and the site of injection.
6. Provide the duration of therapy and any additional necessary details, including Jcode and ICD10, if applicable.
7. Complete the clinical information section by answering questions related to prior treatments and whether the patient has a documented history related to the requested medication.
8. Fill out the attestation section at the bottom of the form and sign to confirm the truthfulness of the provided information.
9. Once you have completed all sections, review the form to ensure accuracy, then save changes, download, print, or share the form as needed.

Ensure timely processing of your request by completing the CIGNA HealthCare Prior Authorization Form online today.