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Forms and Practice Support
FORMS AND PRACTICE SUPPORT
Practice Support
- 360 Comprehensive Assessment Form 2020
- Behavioral Health
- Cigna Medicare ID Cards
- Clinical Practice Guidelines – 2019
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Flyer
- Health Outcomes Survey (HOS) Flyer
- Provider Directory
- Provider Online Portal – Claimstat MCIS (Arizona only)
- Provider Online Portal – HSConnect
- Quick Reference Guide
- Quick Reference Guide – Oncology
- Special Needs Plans Model of Care Training
- Stay Informed – Provider Updates
Precertification Request Forms
- Drug Prior Authorization Request Forms Coverage Determinations
- Drugs/Biologics Part B Precertification Form
- Drugs/Biologics Part B Precertification Form – Part B Step Therapy Remicade
- Drugs/Biologics Part B Precertification Form – Neupogen and Granix
- Drugs/Biologics Part B Precertification Form – Durable Medical Equipment (DME) Diabetic Testing Supplies Request
- Prior Authorization Request Form
- Prior Authorization Request Form – Durable Medical Equipment (DME)
- Prior Authorization Request Form – Home Health Care (HHC)