Cigna Healthcare Prior Authorization

Cigna Healthcare publishes service-specific prior authorization guidance. Start with the payer resource below, then confirm the member's plan and the requested service before care is scheduled or submitted.

At a glance

Cigna Healthcare uses prior authorization/precertification workflows that vary by service type and line of business. Providers can submit through the Cigna for Health Care Professionals portal, EDI 278 via a practice management system/vendor, fax for some services, and phone for some categories. For medications/pharmacy services, Cigna indicates a shift toward electronic prior authorization (ePA) portals, with phone remaining an option if ePA cannot be used.
Prior authorization requirements vary by service type, vendor, and plan.
Cigna notes that oncology pharmacy drug and medical prior authorization may use Medical Oncology Pathways via eviCore/Evernorth.
For medications/pharmacy services, Cigna indicates electronic prior authorizations are preferred and phone is a fallback if ePA cannot be used.
This is provider operational guidance, not a guarantee of coverage or payment.

Where to verify prior authorization requirements

How to submit prior authorization requests

Online portal / prior authorization portal
EDI 278 transaction via practice management system or clearinghouse/vendor
Fax for some precertification forms
Phone for some service categories
ePA portals for medications and pharmacy services
Submission resource 1
Submission resource 2

Information commonly required

Service description
Start date of service
End date of service
Service code if available (HCPCS/CPT)
Appropriate precertification intake form for faxed requests
Behavioral health service-specific forms or requirements from the Form Center / Evernorth Authorization and Billing Resource
For EDI 278 requests, use the vendor/clearinghouse workflow

Turnaround notes and caveats

Some behavioral health emergency admissions must be reported within one business day of admission unless state mandate says otherwise.
The prior authorization pages do not provide a universal turnaround time for all requests; timeframes may vary by service, vendor, and plan.
Prior authorization requirements vary by service type, vendor, and plan.
Cigna notes that oncology pharmacy drug and medical prior authorization may use Medical Oncology Pathways via eviCore/Evernorth.
For medications/pharmacy services, Cigna indicates electronic prior authorizations are preferred and phone is a fallback if ePA cannot be used.
This is provider operational guidance, not a guarantee of coverage or payment.

Provider resources

Cigna for Health Care Professionals portal (official)
Precertification / Prior Authorization (official)
Submit Claims (official)
Appeals and Disputes (official)
CHCP resources: Electronic Claims Submission (official)
CHCP resources: How to Register (official)

Sources

Fact	Value	Source	Confidence
EDI 278 and fax/phone methods	A healthcare provider may send a 278 transaction; fax and phone are also listed for certain request types.	Official	high
Required service details	Medical services requests require description, start date, end date, and service code if available.	Official	high
Behavioral health emergency reporting	Emergency behavioral health inpatient admissions must be reported within one business day unless state mandate says otherwise.	Official	high
ePA transition for pharmacy services	Cigna says coverage reviews are transitioning from PromptPA, fax, and phone to ePA portals.	Official	high

Last reviewed: March 27, 2026

Sources used: 2 official