Submitting Authorization
After registration, you can submit pre-authorization requests directly through the Prior Authorization Lookup Tool.
Submit Request
After clicking Submit Authorization in the Lookup Tool, the system automatically guides through profile confirmation, document signing, and completion of the pre-authorization form. At this stage, details about the provider, patient, and requested service are entered — the fields listed below ensure that each request is accurate, complete, and processed without delays.
Information required to complete the pre-authorization request:
| Field | Description |
|---|---|
| Insurer | Displays insurance details, such as the address and phone number, which is very convenient since you don't have to search for this information online. |
| Line of Business | LOB refers to a category or type of insurance that an insurance company offers. It can be Medicare/Medicaid/PPO/HMO, etc. |
| Type of Authorization Request | Medical/Behavioral Health and Inpatient or Outpatient, Radiology, Cardiology. |
| Priority | Standard or expedited/urgent. |
| Information about the provider delivering the service | Type (Requesting Provider/Servicing Provider/Secondary Provider), NPI/TIN, address, Office location. |
| Patient’s information | First and Last Name, date of birth, ID number, gender, Subscriber ID. |
| Details as the requestor | Name, phone number, fax number, email address. |
| Service Details | Service type (e.g., Medical Care), Location (Place of Service), Level of Service (Basic/Intermediate/Complex), Service Unit (Hours/Sessions/Days), Start Date, End Date or Expected date of service (if one day). |
| CPT Procedure code or Procedure name | Provide the CPT code or name of the procedure. |
| Diagnosis codes | Attach relevant diagnosis codes. |
| Member's clinical documents | Attach the member's documents. |
Documentation Review
The insurance company reviews the submitted documents to ensure that all necessary information is included. This typically takes 1 to 3 business days.