Organization Detail
Cigna / Evernorth
1 plan across 1 state · Exchange Plans
Cigna / Evernorth reported prior authorization metrics for 1 Exchange Plans plan across 1 state under CMS rule CMS-0057-F for calendar year 2025. The average standard prior authorization denial rate was 26%, above the national average of 11.8%. When patients or providers appealed denied prior authorizations, 1% of appeals were overturned on average. Standard prior authorization decisions took an average of 1.1 days.
26.0%
Cigna / Evernorth Denial Rate
standard, avg across 1 plans
11.8%
National Average
all reporting plans
+14.2%
vs. National
above average
MS1 plan
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cigna Healthcare MS Commercial (State Law)Exchange Plans | — | — | — | 74.0% | 26.0% | — | 1.0% | 99.0% | — | — | 1.1 | 0.0 |