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Manage medical and drug authorizations

Some medical services, procedures, durable medical equipment (DME) and drugs require approval before they can be covered by your patients' benefits.

Upon receiving approval, you will be given an authorization number. Please reference this number on all claims related to the specific procedure or service requiring prior approval. Also, remember that services determined as not medically necessary, investigational, or experimental are the liability of the provider.

Step 1 — Verify if authorization is required.

Use the medical authorization table (procedures, imaging and DME) or drug prior authorization list (medications and drugs) to determine if you need an authorization. Also view authorizations for out-of-area members.

View important details about authorizations

Step 2 — Submit an authorization request

Log in to the Provider Portal to submit an authorization.

Submit Medical Authorizations Secure Site Submit Drug Authorizations Secure Site

Step 3 — Check the status of an authorization

Log in to check the status or see if further action is needed.

View Medical Authorizations Secure Site View Drug Authorizations Secure Site

Learn more about response times and notifications

 

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