Get Cigna Pharmacy Credentialing Application 2012-2025

Completing the Cigna Pharmacy Credentialing Application is an important step in joining the Cigna Healthcare Pharmacy Network. This guide provides clear, step-by-step instructions on how to fill out the application online, ensuring that you complete all necessary sections and submit required documents efficiently.

Follow the steps to complete the application accurately

1. Click ‘Get Form’ button to access the application and open it in your preferred format.
2. Begin by filling out section I, which includes providing your legal name, pharmacy details, and contact information. Ensure all entries are typed or printed legibly.
3. Proceed to section II to indicate the type of pharmacy services you provide. Select all applicable boxes and specify the percentage of your business for each type.
4. In section III, answer the questions regarding licensure, certification, and malpractice. Initial where required to indicate your agreement and compliance with the listed statements.
5. Complete section IV by signing and dating the application. Ensure that all information provided is accurate to the best of your knowledge.
6. If applicable, fill out sections V and VI according to the specific requirements for Medicare and long-term care services.
7. Finally, review the entire application for completeness. Make sure all required attachments, such as copies of licenses and liability insurance certificates, are included.
8. Save your changes, and then download, print, or share the completed application as necessary before mailing it to the provided address.

Complete your Cigna Pharmacy Credentialing Application online today to join the network.