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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. 

Medical
Our medical prior authorization guidelines are specific to members who are under HMO plans and assigned to an independent network provider.
View guidelines
Pharmacy
Find out what supporting documentation you’ll need to request prior authorization for medications.
Learn more
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) and Preferred Provider Organization (PPO) plans
Request precertification for members on POS and PPO plans to receive health services from an out-of-network provider.
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