What does pre-certification mean?
Pre-certification is the process of obtaining Cigna's approval before certain healthcare services or procedures are performed. Pre-certification is required for all in-patient admissions and a number of outpatient services, including high-tech radiology procedures such as MRIs and CT scans. For a full list of services or supplies that require pre-certification or pre-notification, log on to myCigna or call Cigna at 800-Cigna24 (244-6442), 24 hours a day, 7 days a week. Failure to get pre-certification when required results in a penalty of 50% before the appropriate coinsurance is applied or, in the case of high tech radiology, the procedure is not covered.
Although your provider may contact Cigna for authorization on your behalf, you’re ultimately responsible for making sure Cigna's approval is obtained or the care or service you receive may not be covered.
If you’re unable to obtain pre-certification due to an emergency, report the emergency to Cigna as soon as possible to comply with this requirement.