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Always check benefits through the Voice Response Unit (VRU) or My Insurance ManagerSM to determine if prior authorization is required.
Many of our plans require prior authorization for certain procedures and durable medical equipment. This process allows us to check ahead of time whether services meet criteria for coverage by a member’s health plan.
In many cases, approval is instant. When it’s not, we’ll review your request, taking into account:
- Our medical policies
- Recognized clinical guidelines
- The terms of the member’s benefit plan
Some requests may require additional documentation.
How to Request Prior Authorization
When you request prior authorization (PA) from us, we want the process to be fast, easy and accurate. We use the Cohere Health platform to provide you with a powerful tool to accelerate the PA process and expand real-time approvals. You can also call 888-801-9617.
You will still sign-on through My Insurance Manager so you can begin the process for medical services, but the portal will route you to the new web-based application, powered by Cohere Health, to enhance the efficiency of PA decisions.
Note: All clinical decisions are made by InStil Health.