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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. Or call Provider Services at 1-855-232-3596 (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:

 

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 1-855-232-3596 (TTY: 711)

By fax

Download our PA request form (PDF). Then, fax it to us at 1-844-797-7601. Be sure to add any supporting materials for the review. 

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