Precertification requirements
To request or check the status of a prior authorization request or decision for a particular plan member, 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.
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Behavioral health
Fax all requests for services that require precertification to:
Services billed with the following revenue codes always require precertification:
| 0240–0249 | All-inclusive ancillary psychiatric |
| 0901, 0905–0907, 0913, 0917 | Behavioral health treatment services |
| 0944–0945 | Other therapeutic services |
| 0961 | Psychiatric professional fees |
Pharmacy
Check our Preferred Drug List
Services billed with the following revenue codes always require precertification:
| 0632 | Pharmacy multiple sources |
Nonparticipating providers
All services you render require precertification.
Fax:
1-800-964-3627
Call:
1-866-231-0847
Related information
Provider tools and resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification lookup tool
- Precertification requirements
- Claims overview
- Member eligibility & pharmacy overview
- Provider manual and guides
- Referrals
- Forms
- Training Academy
- Pharmacy information
- Electronic Data Interchange (EDI)