Services that are medically necessary and a covered benefit under the member's health plan are usually paid for, but certain services require prior authorization before they can be provided. These services, especially those that may result in expensive procedures, undergo the prior authorization process to ensure those services will be covered.

We will make a decision within 15 days of receipt of your request for prior authorization. Read more about "medical necessity," and details about services which require prior authorization in our Provider Handbook. Health Care Services is available to assist you with all prior authorization requests and advance notification requirements.

Prior Authorization Forms

• Request for Prior Authorization
• Prior Authorization for Bariatric Surgery
• Prior Authorization for DEXA Scan
• Prior Authorization for Gene Expression Assay
• Prior Authorization for In Vitro Fertilization
• Prior Authorization for Injectible and Prescription Drug
• Prior Authorization for Photodynamic Therapy
• Prior Authorization for Psychological Testing

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