Cigna Prior Auth Form PDF Details

The Cigna Prior Authorization Form is required before Cigna approves coverage for certain prescription drugs, specialty medications, or medical services. Physicians submit the form on behalf of their patients to confirm medical necessity before treatment begins.

The form collects information across several key areas. The prescriber section requires the physician's name, NPI number, fax number, and office phone number. The patient section requires the Cigna member ID, date of birth, and primary diagnosis code. The treatment section specifies the medication or procedure requested, including dosage, strength, quantity, and clinical indication.

Cigna distinguishes between standard and urgent prior authorization requests. Urgent requests apply when delaying treatment could seriously jeopardize the patient's health. Standard prescription drug coverage requests are reviewed within five business days. Medical benefit requests may follow a different timeline.

Electronic submission is available through CoverMyMeds and SureScripts, which connect directly with pharmacy and hospital systems. Fax submission is also accepted using the fax number printed on the form. Cigna processes each request by reviewing the submitted clinical information against its coverage guidelines before issuing a determination.

QuestionAnswer
Form NameCigna Prior Auth Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namescigna botox prior authorization form, cigna botox pa form, cigna botox form, cigna prior authorization form for botox

How to Edit Cigna Prior Auth Form Online for Free

This PDF editor allows you to complete the Cigna Prior Authorization Form directly in your browser. The steps below walk through each section so the form is filled out accurately and completely.

Step 1: Open the form

Click the orange "Get Form Now" button at the top of this page. The PDF editor launches without any download or installation required.

Step 2: Enter prescriber and patient information

Provide the prescribing physician's name, NPI number, fax number, and office phone number. Then enter the patient's full name, Cigna member ID, date of birth, and the relevant ICD-10 diagnosis code. Complete and accurate information in this section prevents processing delays.

Step 3: Document the requested medication or treatment

Specify the drug name, dosage, strength, and quantity requested. For specialty medications such as Botox injections, include the medical indication and any supporting clinical notes describing the patient's condition.

Cigna prior authorization form alternative medications section

Step 4: Complete the alternative medications section

List any prior medications or generic alternatives the patient has already tried. For each, include the drug name, dates of use, and the clinical outcome or reason for discontinuation. Cigna uses this information when reviewing the authorization request.

Cigna prior authorization form prior treatment history section

In the section asking whether any question above applies, mark Yes or No and complete the follow-up fields as required.

Cigna prior authorization form review type selection

Step 5: Select the review type

Check the appropriate box for standard or urgent review. Urgent review applies when delaying treatment could seriously harm the patient. Standard prescription drug coverage requests are processed within five business days. Submit the completed form by fax to the number shown on the form, or use CoverMyMeds or SureScripts for electronic submission.

Cigna prior authorization form submission contact information

Step 6: Save and distribute the completed form

Click the Done button when all sections are filled in. Download the finished form or send it directly to an email address. Keep a copy for the patient's medical record and the prescribing physician's files.

Looking for other prior authorization forms? See the Cigna Appeal Form for denied requests, the Aetna Pharmacy Prior Authorization Form, or the Antipsychotic Prior Authorization Form.

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