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Pre-Service Review Requirements for Specific Audiences

Unique pre-service requirements apply for out-of-network providers, non-contracted providers and FEP members.


If you are a non-contracted provider, you will be unable to use the online tool. Please use this prior approval form pdf.


Carefully review Federal Employee Program requirements, which may be different from what is outlined in the Authorization Table.


To request authorization for services to be provided by an out-of-network or non-contracted provider, please submit using the Utilization Management Tool - Procedures and DME. See detailed instructions pdf.


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