Cigna Medicare Advantage Provider Resource
Please download and read through the following material. Our goal is to make the change to EviCore as seamless and easy as possible and these documents will explain the process. There is contact information in the material if you have any questions.
If you are looking for Cigna Commercial resources, please visit the Cigna Resources Page.
Effective May 1, 2024, all Radiology, Cardiovascular & Musculoskeletal requests for Cigna Healthcare Medicare Advantage must be submitted using the CareCore National Portal. Additional information can be found on the solution resource page for each program.
Programs and Description
Durable Medical Equipment effective June 1, 2022
EviCore manages precertification for durable medical equipment services for Cigna Medicare Advantage customers with the exception of Arizona Medicare customers.
Home Health Care effective June 1, 2022
EviCore manages precertification for home health care services for Cigna Medicare Advantage customers with the exception of Arizona Medicare customers.
Cigna and EviCore offer a comprehensive oncology program that promotes affordability, predictability, and simplicity.
EviCore searches the National Cancer Institute's oncology clinical trial database to help match customers to clinical trials.
Clinical Consult Service (Arizona Medicare only)
The clinical consult service provides support to community oncologists to enhance patient outcomes.
Community oncologists have the opportunity to collaborate with an oncologist who specializes in the patient’s cancer type and practices at a National Cancer Institute-designated or a National Comprehensive Cancer Network-affiliated cancer center.
The service is available for patients with select cancer diagnoses who have Cigna coverage and may benefit from a review of their diagnosis and treatment plan.
Value-based Pathways Program (Arizona Medicare only)
The value-based pathways program promotes the use of clinically appropriate, safe, and cost-effective therapies to improve patient outcomes.
EviCore manages precertification for Cigna customers in most markets for outpatient and inpatient musculoskeletal services (e.g., interventional pain and joint surgery procedures).
Level of care
Precertification requirements for certain procedures, including total knee replacement and total hip
Post-Acute Care effective June 1, 2022
EviCore manages precertification for post-acute care services for Cigna Medicare Advantage customers.
(Arizona Medicare Only)
EviCore manages precertification for select outpatient radiation therapy services.
Radiology/Cardiovascular 8/23/2010
(Arizona Medicare Only)
EviCore manages precertification for high-tech radiology and diagnostics cardiovascular services.
There are currently no General Resources.
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Cardiovascular
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Durable Medical Equipment
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Home Health
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Medical Oncology
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Musculoskeletal
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Oncology Benefits Management
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Post-Acute Care
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Radiation Oncology
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Radiology
Musculoskeletal
Radiation Oncology
Cardiovascular
Radiology
Durable Medical Equipment
Home Health
Medical Oncology
Post-Acute Care
Oncology Benefits Management
Need Help?
Registration Instructions
EviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider
Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.