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Prior authorization

Prior authorization (PA) is required for acute outpatient services and planned hospital admissions. We don’t require PA for emergency care. You can find out if a service needs PA by using ProPAT, our online prior authorization search tool.

 

Search ProPAT

 

Questions?

Check out your provider manual (PDF). Or call Provider Experience at 1-855-221-5656 (TTY: 711).

Tips for requesting prior authorization

Tips for requesting prior authorization

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:

 

 

How to request prior authorization

 

You can request PA:

Online

Ask for PA through our Provider Portal.

By phone

For urgent PA requests, you can call us at 1-855-221-5656 (TTY: 711)

By fax

Download and complete one of our PA request fax forms. Then, fax it to us at 1-855-225-4102.

 

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

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