Simplifying and reducing prior authorization with industry peers
AI Summary
Cigna Healthcare is joining other health plans to standardize electronic prior authorization submission requirements and reduce the number of services requiring prior authorization. By end of 2026, standardized electronic prior auth will apply to medical services representing more than 70% of Cigna's prior authorization volume, with additional reductions and improvements rolling out through 2027.
Action Required
By end of 2026: Billing team must prepare for standardized electronic prior authorization submission requirements for approximately 70% of current Cigna prior auth volume. Monitor for updated service lists and new electronic submission processes. Update billing workflows to accommodate real-time prior auth responses and 90-day continuity periods for new enrollees. Failure to adapt to new electronic submission standards may delay patient care access.
Plan Types
Commercial
Specialties
all-specialties