Another group or vendor provides the info on the next page. If you don’t want to leave our site, choose the “X” in the upper right corner to close this message. Or choose “Go on” to move forward.
Prior authorization
Prior authorization is required for some out-of-network providers, 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.
Questions?
Check out your provider manual (PDF). Or call 1-844-365-4385 (TTY: 711). We’re here for you 8 AM to 5 PM, Monday to Friday.
Tips for requesting PA
.jpg)
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 correct form for all medical requests.
- Attach supporting documents when you submit the form.
Here are the PA forms you may need:
Physical health prior authorization request form (PDF)
Behavioral health prior authorization request form (PDF)
Behavioral health acute and residential prior authorization request form (PDF)
How to request PA
You can request PA:
By phone
Ask for PA by calling us at 1-844-365-4385 (TTY: 711). We’re here for you 8 AM to 5 PM, Monday to Friday.
By fax
Download the correct PA request form from the “Tips for requesting PA” section of this page. Then, fax it to us at the number on the corresponding PA request form.
And be sure to add any supporting materials for review.