Cigna (Express Scripts) Letter of Medical Necessity Guide
How to write an LMN and overturn a prior authorization denial with Cigna (Express Scripts). Includes denial reasons, turnaround times, appeals address, and clinician tips.
Quick Facts
- Avg Turnaround: 30 days standard, 72h expedited
- Appeals Address: Cigna Appeals Unit, PO Box 188011, Chattanooga, TN 37422
- Provider Portal: https://cignaforhcp.cigna.com/
Why Cigna Denies Prior Authorizations
- 1. Step edit not satisfied
- 2. Off-label use
- 3. Missing genetic testing
- 4. Dose exceeds FDA label
Clinician Tips for Cigna
- ✓ Reference Cigna Coverage Policy (CP) number
- ✓ Express Scripts handles Rx — submit via CoverMyMeds
- ✓ Expedited appeals require attestation of urgency
Cigna Coverage Policies are public — link to the exact CP in your LMN.
Cigna Prior Authorization FAQ
Why does Cigna deny prior authorizations?
The most common Cigna denial reasons are: Step edit not satisfied; Off-label use; Missing genetic testing; Dose exceeds FDA label.
How long does Cigna take to review a prior authorization?
Cigna typically responds in 30 days standard, 72h expedited.
What should a Letter of Medical Necessity for Cigna include?
An LMN for Cigna (Express Scripts) should reference the specific medical policy or coverage bulletin, document failed first-line therapies with dates, include current labs and ICD-10 codes, and cite supporting clinical guidelines. Cigna Coverage Policies are public — link to the exact CP in your LMN.