Prior authorization requirements

The preferred method to request or check the status of a prior authorization request or decision for a particular plan member is to 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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Physical health

Precertification requests and inpatient notification fax:

877-269-5705

Concurrent inpatient clinical fax:

888-822-5595

Outpatient fax:

888-822-5658

Durable medical equipment fax:

844-528-3684

Behavioral health

Fax all requests for services that require prior authorization to:

Inpatient:

844-432-6027

Outpatient:

844-432-6028

Pharmacy

Check our Preferred Drug List or see the formulary information on the Pharmacy Information page to use our searchable formulary tool.

Pharmacy prescription drug prior authorization fax:

800-424-7402

Pharmacy medical injectable prior authorization fax:

844-487-9291

Member and Pharmacy Help Desk Phone Number:

1-800-424-1664

Heathy Blue Dual Advantage

Dual Advantage Prior Authorizations — Utilization Management

Phone:

800-262-2731

Fax:

877-423-9972

The following always require prior authorization:

Elective services provided by or arranged at nonparticipating facilities.

Nonparticipating providers

All services you render require prior authorization:

Call

844-521-6942

Obtain prior authorization from our vendors

Hi-tech radiology, cardiology, and sleep medicine

AIM Specialty Health^®:

833-342-1254

Aim Specialty Health®

Laboratory services and diagnostic testing

LabCorp:

800-345-4363

LabCorp

Quest Diagnostics^TM:

866-MY QUEST (866-697-8378)

Quest Diagnostics™

Nonemergency transportation

MediTrans:

Meditrans phone:

866-430-1101

MediTrans

Dedicated provider line:

844-349-4324

Vision services

SuperiorVision^®:

866-819-4298

SuperiorVision®

Top Searches

Prior authorization requirements

Don’t have an Availity account?

Need help with Availity?

Physical health

Precertification requests and inpatient notification fax:

Concurrent inpatient clinical fax:

Outpatient fax:

Durable medical equipment fax:

Behavioral health

Fax all requests for services that require prior authorization to:

Inpatient:

Outpatient:

Pharmacy

Pharmacy prescription drug prior authorization fax:

Pharmacy medical injectable prior authorization fax:

Member and Pharmacy Help Desk Phone Number:

Heathy Blue Dual Advantage

Dual Advantage Prior Authorizations — Utilization Management

Phone:

Fax:

Nonparticipating providers

All services you render require prior authorization:

Call

Obtain prior authorization from our vendors

Hi-tech radiology, cardiology, and sleep medicine

AIM Specialty Health^®:

Laboratory services and diagnostic testing

LabCorp:

Quest Diagnostics^TM:

Nonemergency transportation

MediTrans:

Meditrans phone:

Dedicated provider line:

Vision services

SuperiorVision^®:

Related Information

Provider tools & resources

Interested in becoming a provider in our network?

Top Searches

Prior authorization requirements

Don’t have an Availity account?

Need help with Availity?

Physical health

Precertification requests and inpatient notification fax:

Concurrent inpatient clinical fax:

Outpatient fax:

Durable medical equipment fax:

Behavioral health

Fax all requests for services that require prior authorization to:

Inpatient:

Outpatient:

Pharmacy

Pharmacy prescription drug prior authorization fax:

Pharmacy medical injectable prior authorization fax:

Member and Pharmacy Help Desk Phone Number:

Heathy Blue Dual Advantage

Dual Advantage Prior Authorizations — Utilization Management

Phone:

Fax:

Nonparticipating providers

All services you render require prior authorization:

Call

Obtain prior authorization from our vendors

Hi-tech radiology, cardiology, and sleep medicine

AIM Specialty Health®:

Laboratory services and diagnostic testing

LabCorp:

Quest DiagnosticsTM:

Nonemergency transportation

MediTrans:

Meditrans phone:

Dedicated provider line:

Vision services

SuperiorVision®:

Related Information

Provider tools & resources

Interested in becoming a provider in our network?

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AIM Specialty Health^®:

Quest Diagnostics^TM:

SuperiorVision^®: