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Get Cigna Genetic Testing Recommendation Form 2018-2025
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How to fill out the Cigna Genetic Testing Recommendation Form online
Filling out the Cigna Genetic Testing Recommendation Form is an important step in the process of obtaining genetic testing. This guide will walk you through each section of the form, ensuring that you provide all necessary information clearly and accurately.
Follow the steps to complete the form effectively.
- Press the ‘Get Form’ button to obtain the form and open it for filling out.
- Begin by entering your customer (patient) information, which includes your full name, Cigna customer ID, date of birth, and the date of consultation.
- Provide the ordering health care provider's information. This includes their name, Taxpayer Identification Number (TIN), street address, telephone number, city, state, ZIP code, and fax number.
- If applicable, enter the clinical geneticist, genetic counselor, advanced genetics nurse, or advanced practice nurse in genetics information, ensuring to provide their name, street address, telephone number, city, state, ZIP code, and fax number.
- Fill in the rendering laboratory information by providing the laboratory name, TIN, street address, telephone number, city, state, ZIP code, and fax number.
- List the relevant diagnosis codes by including the appropriate ICD-10 codes in the designated area.
- Indicate the requested test(s) information, specifying the names of the tests and the related CPT/HCPCS codes. Additionally, note if this is a panel test by selecting 'Yes' or 'No.'
- Choose the appropriate recommendation based on the individual’s medical coverage policy criteria, providing any necessary justification or alternative testing options if required.
- Respond to the statements listed on the form to affirm your credentials and confirm the attached documentation, if applicable.
- Sign and date the form to complete the process before submitting.
- After completing the form, save your changes. You can download, print, or share the document as needed.
Complete the Cigna Genetic Testing Recommendation Form online today for efficient processing!
Cigna may cover genetic testing that assists in medication management, particularly if it can enhance treatment effectiveness or reduce adverse effects. The necessity of the test must be documented in the Cigna Genetic Testing Recommendation Form to ensure approval. For a clearer understanding of your options, exploring resources on the US Legal Forms platform can provide valuable insights.
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