Prior authorization requirements
To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.
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Behavioral health
Fax all requests for services that require prior authorization to 877-664-1499.
Services billed with the following revenue codes ALWAYS require prior authorization:
-
0240-0249
- All-inclusive ancillary psychiatric 0901
- Behavioral health treatment services 0905-0907
- Behavioral health treatment services 0913
- Behavioral health treatment services 0917
- Behavioral health treatment services 0944-0945
- Other therapeutic services 0961
- Psychiatric professional fees
Pharmacy
Check our Preferred Drug List
Services billed with the following revenue codes ALWAYS require prior authorization:
-
0632
- Pharmacy multiple sources
