There may be times when you have an urgent need to appeal a coverage denial or partial coverage denial for your patient, and receive a decision very quickly to speed the start of treatment. In these situations, you may be able to request an expedited appeal, but only if services have not been performed and meet the criteria below. Your expedited appeal notification also helps us notify enrollees of their additional appeals rights as applicable and helps us improve our response times.

You may file an expedited appeal when:

• The patient is currently hospitalized, a decision was made to discharge the patient earlier than the provider requested, and the patient is awaiting continued care, or
• The patient is in severe pain that cannot be adequately managed without the treatment requested, or
• A delay in treatment may jeopardize the patient’s life, health, or ability to regain maximum functionality.

Help us triage your request:

When time is of the essence, it may seem helpful to label all expedited appeals as “urgent.” However, this can actually cause delays in processing as these submissions occupy space in the inventory of appeals to process alongside truly urgent appeals, which challenges appropriate prioritization. Please help us be as nimble and responsive as possible by labeling expedited appeals “urgent” only when urgent.

How to request an expedited appeal

If your pre-service appeal meetsone or more of the scenarios described above, fax the appeal to:

Cigna Healthcare National Appeals Organization
Attn: Expedited Appeals

Fax: 860.731.3452
Clearly note “Expedited Appeal” on the first page of your submission.

Please also include the following information:

• Patient name
• Date of birth
• Cigna Healthcare ID #
• Denied Authorization Number (if applicable)
• All supporting clinical information