Prior authorization

Quality health care with no surprises.

We work closely with our providers to ensure that health care is safe, necessary, appropriate and cost effective. Be sure to refer to our prior authorization guidelines for covered procedures, services and medications before you perform a service or prescribe. 

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Medical

Our medical prior authorization guidelines are specific to members who are under HMO plans and assigned to an independent network provider.

View guidelines
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Pharmacy

Find out what supporting documentation you'll need to request prior authorization for medications.

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Behavioral health

See what mental health and substance use disorder services require prior authorization for our commercial plan members.

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Pre-certification for Point of Service (POS) plans

Request precertification for members on POS plans to receive health services from an out-of-network provider.

Get the form