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Search quickly and easily by CPT code: Authorization Lookup tool

Prior Authorization Required Information

The following information is generally requested for all authorizations: 
  • Member name
  • Member identification number
  • Provider ID and NPI number or name of the treating physician
  • Facility ID and NPI number or name where services will be rendered (when appropriate)
  • Provider and/or facility fax number
  • Date(s) of service
  • Diagnosis and diagnostic codes
  • CPT codes
  • Any relevant clinical information to support medical necessity of request 

Providing complete information allows for timely processing by the Prior Authorization Department. 

How to Obtain an Authorization

Registered providers may log in, click the Authorizations tab, then select Authorization Request. 

Please supply your phone and fax numbers. You can attach up to 10 clinical files, and also add relevant clinical information by typing it into the text box. Your requests may not be visible in the Provider Portal inquiry until a final disposition has been determined. As a result, you may receive our fax response prior to seeing the determination online. 

You may also contact the Prior Authorization Department seven days per week, 24 hours per day: 

  • To obtain medical and behavioral health authorizations, call 1-800-322-6027.
  • Fax your authorization request to 1-866-946-2052.
  • For pharmacy authorizations, call 1-800-392-8030.  

Authorization Forms

Please visit our Provider Forms page to find authorization requests.


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Last Updated On: 12/14/2015