To request or check the status of a prior authorization request or decision, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.
Services billed with the following revenue codes always require prior authorization:
If you are unable to submit the request online through the Availity Portal, please fax requests to:
Inpatient — 1-877-434-7578
Outpatient — 1-866-877-5229
Check out our Preferred Drug List (PDL).
Services billed with the following revenue code(s) always require prior authorization:
0632 — Pharmacy multiple sources
Providers needing an authorization should call 1-877-440-3738.
The following always require prior authorization:
Elective services provided by or arranged at nonparticipating facilities
All services billed with the following revenue codes:
0023 — Home health prospective payment system
0570–0572, 0579 — Home health aide
0944–0945 — Other therapeutic services
3101–3109 — Adult day and foster care