Utilization management

Our prior authorization guide makes it easy to determine when prior authorization is required for a particular service. Note that these guidelines are specific to services for members enrolled in an HMO plan and assigned to providers who are independently contracted with us.

If you would like to prescribe a medication that requires authorization, you’ll need to fill out the prior authorization request form and give us any relevant support or documentation. Once the form is complete, we can review your request.

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