Cigna HealthCare of Arizona, Prior Authorization

Cigna HealthCare of Arizona, prior authorization rules are often service-specific rather than universal, so the safest workflow is to confirm the requirement in the payer's provider resources before scheduling or submitting care. The notes below summarize the most actionable provider-side guidance captured in the research set for this payer.

At a glance

• Cigna states that providers can submit prior authorization/precertification requests electronically through Cigna’s online prior authorization tool, or by fax. For Arizona medical providers, the instruction sheet says to register for the online tool by emailing PMAC@Cigna.com, and if faxing, send the form to 866.873.8279. Cigna also directs providers to call the phone number on the member ID card or 800.244.6224 (800.Cigna24) for Coverage Review Team contact.
• The Arizona instruction sheet is for medical providers and may not apply to pharmacy or behavioral health prior authorizations.
• Cigna notes that the type of services managed through precertification can vary, including use of eviCore or other national ancillary vendors.
• Prior authorization is not a guarantee of payment.

Where to verify prior authorization requirements

• Verification resource 1
• Verification resource 2

How to submit prior authorization requests

• Online prior authorization tool

• Fax

• Phone

• Submission resource 1

• Submission resource 2

Information commonly required

• Provider or facility name
• Mailing address
• Email address
• Contact name
• Contact telephone number
• Description of service
• Start date of service
• End date of service
• Service code if available (HCPCS/CPT)

Turnaround notes and caveats

• No general prior authorization turnaround time was located in the cited official provider guidance.
• For appeals related to prior authorization or claim disputes, Cigna states reviews may be completed in 60 days and dispute resolution is communicated within 75 business days of receipt of the original dispute.
• The Arizona instruction sheet is for medical providers and may not apply to pharmacy or behavioral health prior authorizations.
• Cigna notes that the type of services managed through precertification can vary, including use of eviCore or other national ancillary vendors.
• Prior authorization is not a guarantee of payment.

Provider resources

• Cigna for Health Care Professionals portal (official)
• Precertification and prior authorization overview (official)
• Arizona prior authorization form instructions (official)
• Timely filing / When to file (official)
• How to file a claim (official)
• Appeals and disputes (official)
• EDI vendors / electronic claims and eligibility vendors (official)

Sources