Phoenix Health Plans Prior Authorization Form
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People also ask
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What is the phone number for BCBS of Arizona prior authorization?
If you have questions about a newly released or changed item, or whether prior authorization is required, please call us at 602-864-4320 or 1-800-232-2345. Prior authorization is not a guarantee of payment.
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Who is responsible for obtaining preauthorization?
Prior authorization in health care is a requirement that a healthcare provider (such as your primary care physician or a hospital) gets approval from your insurance plan before prescribing you medication or doing a medical procedure.
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What items are needed to submit a prior authorization request?
to the insurer: • Patient name, date of birth, insurance policy number, and other relevant information. • Physician and facility information (eg, name, provider ID number, and tax ID number) • Relevant procedure and HCPCS codes for products/services to be provided/performed.
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What are the most common ways that prior authorization can be performed?
These steps are usually done manually, often through a cascade of phone calls, faxes and emails between payer and provider. The responsibility falls on the provider to continue to follow up with the insurance company until there is resolution of the prior authorization request — an approval, redirection, or denial.
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What is outpatient prior authorization?
Outpatient prior authorization exists to make sure that coverage is available and that the most appropriate treatment is used for certain outpatient services and injectable drugs. Certain outpatient services must be prior authorized utilizing criteria developed and approved by the Medical Advisory Council.
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Is doing prior authorizations hard?
Prior authorization is a time-consuming, labor-intensive, and often frustrating process. Requests require several steps, and there's often a lot of back and forth with payers, especially if the initial request isn't accurate and complete.
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How do I submit a prior authorization to AHCCCs?
Use of the AHCCCS Online Provider Portal is the preferred method of submitting prior authorization requests for Fee-For-Service members. Online submission allows PA staff to process authorization requests efficiently and quickly. Authorization requests automatically generate a Pended Authorization or Case Number.
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How to process prior authorization?
How To Get Prior Authorization: Step-by-Step Guide Step 1: Check client eligibility. ... Step 2: Determine if a code or service requires Prior Authorization. ... Step 3: Find and complete forms. ... Step 4: Submit a PA request. ... Step 5: Check the status of an authorization.
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