Today 39 s option prior auth forms 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Provider Information' section. Enter your name, specialty, DEA or TIN, office contact person, and phone details.
3. Next, complete the 'Patient Information' section. Ensure you provide all asterisked (*) items such as patient name, CIGNA ID, date of birth, and address.
4. In the 'Medication Requested' field, select the appropriate Enbrel dosage and specify the duration of therapy along with any relevant J-Code.
5. Indicate where the medication will be obtained by selecting from options like retail pharmacy or CIGNA Tel-Drug.
6. For diagnosis related to use, check all applicable conditions such as Rheumatoid Arthritis or Psoriatic Arthritis.
7. Finally, review all sections for completeness before submitting via fax at (800)390-9745. Ensure that all required fields are filled to avoid delays.

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