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This form is used to advise Medicare of the person or persons you have chosen to have access to your personal health information. ESTA is an automated system that determines the eligibility of visitors to travel to the United States under the Visa Waiver Program (VWP).Response: All authorizations must be in writing and signed. We intend e-mail and electronic documents to qualify as written documents. A full list of CPT codes are available on the CignaforHCP portal . However, WE WILL ONLY ACCEPT ELECTRONIC SUBMISSIONS at this time. The documents on this website are PDFs. Enter only one provider number per application form. Step 3: Find and complete forms. Step 4: Submit a PA request.