Questions?
Check out your provider manual (PDF). Or call Provider Relations at 1-855-456-9126 (TTY: 711).
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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 with these tips:
- Register for Availity if you haven’t already.
- Verify member eligibility before providing services.
- Complete and send the PA request form (PDF) for all requests.
- Attach supporting documents when you submit the form.
How to request PA
You can request PA:
By phone
Ask for PA by calling us at 1-855-456-9126 (TTY: 711).
By fax
Download our PA request form (PDF). Then, fax it to us at 1-855-474-4978.
And be sure to add any supporting materials for the review.
By email
Ask for PA via email.