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How do I fill this out?
To fill out the Cigna Physician Referral Form, start by entering the primary care physician's information. Next, provide the patient's details and the specialist's information required for the referral. Ensure all sections are filled completely before submitting the form.
How to fill out the Cigna Physician Referral Form Submission?
1
Enter the Primary Care Physician (PCP) information.
2
Fill in the patient details accurately.
3
Provide the specialist's information including name and address.
4
Complete the diagnosis and specialty type.
5
Submit the form via fax, mail, or phone.
Who needs the Cigna Physician Referral Form Submission?
1
Healthcare providers submitting referrals to specialists.
2
Patients requiring referrals to see a specialist.
3
Insurance agents facilitating patient referrals.
4
Administrative staff handling referral documentation.
5
Specialists needing referral confirmation from patients.
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1
Open the Cigna Physician Referral Form in PrintFriendly.
2
Click on the fields you want to edit.
3
Enter the necessary information as required.
4
Save your changes by downloading the document.
5
Finalize your edits before submission.
What are the instructions for submitting this form?
To submit the Cigna Physician Referral Form, you can fax it to 1.866.873.8279. Alternatively, mail it to Cigna, Attn. Precertification and Referral Department, 2nd Floor, 1640 Dallas Parkway, Plano, TX 75093. For immediate assistance, call Cigna Customer Service at 1.866.494.2111.
What are the important dates for this form in 2024 and 2025?
Important dates for submission include regular check-ins every quarter. Updates to health plans may occur in mid-year, requiring timely referrals. Always confirm if there are any changes announced by Cigna for your specific plan.
What is the purpose of this form?
The purpose of the Cigna Physician Referral Form is to streamline the referral process for patients needing specialized care. It ensures that all relevant information is accurately transferred to specialists, facilitating efficient treatment. Proper use of this form can enhance communication between healthcare providers and improve patient outcomes.
Tell me about this form and its components and fields line-by-line.
- 1. Primary Care Physician Information: This section includes details about the PCP, such as name, address, contact number, and TIN.
- 2. Patient Information: This part captures the patient's name and date of birth.
- 3. Specialist Information: Details needed for the specialist, including name, address, and specialty type.
- 4. Diagnosis: A field for the referring diagnosis related to the patient's condition.
- 5. Submission Methods: Instructions for submitting the completed form via fax or mail.
What happens if I fail to submit this form?
If the Cigna Physician Referral Form is not submitted correctly, referrals may be delayed. It is crucial to provide complete information to avoid challenges in processing the request.
- Referral Delays: Incomplete forms can cause significant delays in patient care.
- Inaccurate Information: Missing or wrong information may lead to confusion for specialists.
- Rejection of Submission: The form may be returned for incorrect or missing details, necessitating resubmission.
How do I know when to use this form?
- 1. General Referrals: For routine referrals to specialists by PCPs.
- 2. Urgent Care Needs: To expedite urgent specialist visits.
- 3. Follow-Up Visits: For patients requiring continued specialized care.
- 4. Diagnostic Testing Referrals: To refer patients for tests that specialists perform.
- 5. Consultations: For initial consultations with specialists.
Frequently Asked Questions
How do I fill out the referral form?
Start by entering the primary care physician's details, followed by the patient's and specialist's information.
Can I edit the PDF before downloading?
Yes, PrintFriendly allows you to edit the PDF document directly.
How do I submit the completed form?
You can fax, mail, or call the Cigna referral department with the completed form.
Is there a directory for participating specialists?
Yes, visit Cigna.com/hcpdirectory to find approved specialists.
What if I don’t complete all sections?
Incomplete forms will be returned and require resubmission.
Can I print the form after editing?
Absolutely, you can easily print the edited document after making changes.
How can I share the referral form?
Use the sharing features on PrintFriendly to send the form via email or social media.
What should I do if I can't find a specialist?
Contact Cigna Customer Service for assistance in finding a network provider.
Can I attach additional documents?
Additional documents may be submitted with the referral form as needed.
What is the fax number for submission?
The fax number for submitting the form is 1.866.873.8279.
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