Review your denial letter carefully. Identify the specific reason for the rejection. Common reasons include prior authorization failure, exceeding formulary limits, or insufficient medical justification.
Gather supporting documentation. This might include:
- Your doctor’s letter clearly stating the medical necessity of Cialis for your condition. Medical records illustrating your condition and treatment history. Any relevant peer-reviewed studies supporting the use of Cialis for your specific case.
Contact your doctor. Discuss the denial and ask them to submit additional information to Cigna on your behalf. A stronger, more detailed appeal from your physician significantly improves your chances.
Submit a formal appeal to Cigna. Use their designated appeal process, including all required forms and supporting documentation. Maintain copies of everything you submit.
Follow up. After submitting your appeal, wait for Cigna’s response. If you don’t hear back within a reasonable timeframe (check your policy for specifics), contact Cigna directly to inquire about the status of your appeal.
Consider a second opinion. If your initial appeal fails, consult another physician. They may offer a different perspective or provide additional documentation to strengthen your case for a second appeal.
Explore patient assistance programs. Pharmaceutical companies often offer programs to help patients afford medications. Check Cialis manufacturer’s website for details.
Carefully read Cigna’s appeal instructions. Keep records of all communication with Cigna. Be persistent and polite throughout the process.
