Home Providers Coverage and Claims Prior Authorization

Prior Authorization

How to request precertifications and prior authorizations for patients.

Depending on a patient's plan, you may be required to request a prior authorization or precertification for any number of prescriptions or services. A full list of CPT codes are available on the CignaforHCP portal.

For Medical Services

  • Description of service
  • Start date of service
  • End date of service
  • Service code if available (HCPCS/CPT)

For Pharmacy Services

To better serve our providers, business partners, and patients, the Cigna HealthcareSM Coverage Review Department is transitioning from PromptPA, fax, and phone coverage reviews (also called prior authorizations) to Electronic Prior Authorizations (ePAs). ePAs save time and help patients receive their medications faster. Moving forward, please use one of the following portals below.

If you are unable to use electronic prior authorization, you can call us at 1 (800) 882-4462 to submit a prior authorization request.

Choose a Prior Authorization Portal to Get Started

EviCore® by Evernorth

Conveniently manage your medical and pharmacy drug prior authorization with EviCore by Evernorth.

For both oncology pharmacy drug and medical prior authorization for Cigna Healthcare patients, please choose the option for Medical Oncology Pathways. For other pharmacy drug prior authorization for Cigna Healthcare patients, please choose the option for Pharmacy Drugs (Express Scripts® Coverage).

Learn more about EviCore by Evernorth

Surescripts® 

Connect to all Pharmacy Benefit Manages (PBMs) and payers with ePA from Surescripts. We can help you easily submit ePA requests and save you valuable time if you haven’t fully integrated ePA into your EHR workflow.

Learn more about Surescripts

CoverMyMeds® 

CoverMyMeds is a one-stop solution that works for all medications and all payers.

Learn more about CoverMyMeds

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