CignaMedium ImpactAdministrative
New faxable Residential Prior Authorization Request Form
Published May 5, 2026Effective May 4, 2026
AI Summary
Evernorth Behavioral Health now offers a new faxable form option for submitting residential prior authorization requests to reduce administrative burden. Providers can now fax requests to 833.213.9320 using the new Residential Prior Authorization Request Form instead of only calling.
Action Required
Immediately: Download the new Residential Prior Authorization Request Form from Provider.Evernorth.com > Forms Center. Train staff on the new fax submission option (833.213.9320) for residential behavioral health prior auths. Continue to complete forms entirely and include all required clinical information from page three. Share form with all relevant staff members.
Plan Types
All Plans
Specialties
psychiatry