Prior authorization to Cigna

A large share of Cigna prior authorization requests — including most imaging, oncology, musculoskeletal procedures, and specialty pharmacy — are routed through eviCore rather than Cigna directly. Submitting to the wrong portal is one of the leading causes of delayed decisions on Cigna PAs. Check Cigna's online coverage tool before starting to confirm whether your specific CPT code routes through eviCore or Cigna's own portal, and use eviCore's stricter clinical criteria when building your justification.

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Cigna

CommercialMedicare Advantage

PA Fax: +18005249914
PA Phone: +18008665195
Standard turnaround: 3 business days
Urgent turnaround: 72 hours

Include diagnosis code, CPT code, and clinical rationale. Cigna accepts fax and eviCore portal.

Cigna provider portal →

What you'll need

★ PortalFaxPortal preferred

Form required

eviCore clinical review (imaging, oncology, musculoskeletal, and specialty Rx)

☐Check if procedure routes through eviCore (imaging, oncology, MSK, specialty Rx)
☐Ordering provider NPI
☐Patient member ID
☐ICD-10 diagnosis code(s)
☐CPT procedure code(s)
☐Detailed clinical rationale (eviCore criteria are strict)
☐Rendering provider NPI

▶Common denial reasons

⚠eviCore criteria not met — attach clinical guidelines and peer-reviewed support
⚠Submitted to wrong portal (many Cigna PAs go through eviCore, not Cigna directly)
⚠Clinical rationale too vague — be specific about why alternatives failed
⚠Missing rendering provider information

Verified 2026-05-20. Check payer site for current rules →

From $2.99 per submission

PA Agent requires an account so you can track submissions, record outcomes (approved/denied), and pre-fill appeals automatically. It's free to join.

You can preview the form below — sign in before generating or submitting.

⬆ Import from CSVDownload template

Submission checklist

○Provider name, NPI, practice name

○Provider phone & fax number

○Patient name, DOB, member ID

○ICD-10, diagnosis, CPT, procedure

○Clinical notes (min 50 chars · 0 entered)

✓Fax destination number

○AI justification generated & reviewed

1 of 7 checks complete

Prior Authorization Request

1. Provider Information

Provider Name *

NPI * (10 digits)

Practice Name *

Provider Phone *

Provider Fax *

2. Patient & Insurance

Patient Name *

Date of Birth * (MM/DD/YYYY)

Member ID *

Group Number

💬 Patient notifications: add the patient's email below and they'll automatically receive an email when you record the insurer's decision on the tracking page — no phone call needed.

Patient Email (for outcome notifications)

Patient Phone (for future SMS notifications)

3. Clinical Details

ICD-10 Code *

Diagnosis Description *

CPT Code * (5 digits)

Procedure Description *

Urgency

4. Clinical Notes

Provider notes & supporting rationale *(min 50 chars)0/10000

5. AI Clinical Justification

PHI notice: Clicking “Generate with AI” sends clinical notes and diagnosis to OpenAI for processing. Do not include information beyond what is clinically necessary. Review your organization's policies before submitting patient data to third-party AI services.

6. Submission Method

✓ Pre-filled with Cigna's PA fax number.