Insurer Appeal Playbook
How to Appeal a Cigna Healthcare Denial
Cigna Healthcare denied 11% of standard prior-authorisation requests in calendar year 2025 and overturned 72% of those denials upon provider appeal (KFF analysis of CMS-0057-F insurer disclosures, August 2026).
Published Overturn Rate:
72%
PA Denial Rate: 11%
Verified: Quarter 3, 2026
Cigna Healthcare Appeal Levels & Timely Filing Windows
Stage 01
Level 1 Appeal
Deadline: 180 days from remit
Format: Cigna single-page appeal form + documentation
Stage 02
Level 2 Appeal
Deadline: 60 days from Level 1 letter
Format: Committee review submission
Winning Appeal Tactics for Cigna Healthcare
Highlight Eviti oncology or CareCore radiology authorization cross-reference keys
Document failure of alternative conservative therapies in chronological bulleted tables
Most Common Cigna Healthcare Denial Triggers
01. CO-197 (Pre-cert)
02. CO-50 (Medical Necessity)
03. CO-45 (Contract fee dispute)
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