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Prior authorization

Providers need prior authorization (PA) for some outpatient care and planned hospital admissions. We don’t require PA for emergency care. You can find a current list of the services that need PA on the Provider Portal. You can also find out if a service needs PA by using ProPAT, our online prior authorization search tool. 

Search ProPAT

Need more info?

Check out your provider manual (PDF). Or call Provider Relations at 1-855-242-0802 (TTY: 711).

Tips for requesting PA

Tips for requesting PA

A request for PA doesn’t guarantee payment. We can’t reimburse you for unauthorized services. You can make requesting PA easier by:

 

  • Registering for the Provider Portal if you haven’t already
  • Verifying member eligibility before providing services
  • Completing the PA request form (PDF) for all medical requests
  • Attaching supporting documents when you submit the form 

How to request PA

 

Here are the ways you can request PA:

Online

Ask for PA through our Provider Portal.

By phone

Ask for PA by calling us at 1-855-242-0802 (TTY: 711).

By fax

Download our PA request form (PDF). Then, fax it to us at one of these numbers:

 

And be sure to add any supporting materials for the review. 

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