CommercialPrior AuthHigh impact
EviCore by Evernorth to manage new precertification programs for Cigna Healthcare customers
Cigna·Cardiology, Cardiothoracic Surgery, Orthopedics +1 more·General
Effective date
Nov 1, 2024
We identified it
Jun 19, 2026
Summary
Starting November 1, 2024, EviCore by Evernorth will manage precertification for Cigna Healthcare customers for cardiac/vascular intervention procedures, spine surgery and related procedures, and molecular laboratory tests. Providers must obtain precertification through EviCore for these services instead of directly through Cigna.
Action Required
By November 1, 2024: Billing team must update prior authorization workflow to submit requests to EviCore by Evernorth instead of Cigna for cardiac/vascular interventions, spine surgeries, and molecular lab tests. Staff should attend EviCore orientation sessions in October/November to understand new precertification process. Update billing system reminders and staff training materials. Claims will likely be denied without proper EviCore precertification.