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Expand the appropriate service type category to locate our CareAdvance Provider navigation guide, WebEx and tip sheet.
Please click here to access FAQs Opens a PDF.
If you receive an error message stating "You have no associated provider sets", we can help you;
please email your Web Username and Individual or Group NPI to CAPAdministrator@excellus.com to update the system.
If you have any questions, please contact your Provider Relations Representative.
GLO-PRV-Authorization-Clear Coverage-Hide Clear Coverage app and remove links
GLO-PRV-Authorization-Clear Coverage-Hide Clear Coverage app and remove links
Page Title for page template
Request Authorization
Search for Required Medical Services-Request Authorization Page Tab Content
Request Authorization Row 1 Content
Nested Applications
Request Authorization Accordion (new)
Safety Net:
Medicaid, Child Health Plus, Essential Plan
Safety Net:
Medicaid, Child Health Plus, Essential Plan
Online with eviCore healthcare
or call 1-866-889-8056
Note: Safety Net (excluding Essential) for MSK services only: call 1-800-363-4658
Commercial & Medicare:
Online with CareAdvance Provider
or call: 1-800-363-4658
- CareAdvance Inpatient Navigation GuideOpen a PDF
- CareAdvance Inpatient WebEx - 8.3MB
(click to download) - CareAdvance Outpatient Navigation GuideOpen a PDF
- CareAdvance Outpatient WebEx - 7.5MB
(click to download) - CareAdvance Tip SheetOpen a PDF
Behavioral Health Fax and Request Forms Opens a dialog
Once the preauthorization has been obtained, call Behavioral Health Utilization for the clinical review: 1-800-277-2138
Safety Net:
Medicaid, Child Health Plus, Essential Plan
Online with CareAdvance Provider
call: 1-844-694-6411, or Fax: 1-844-878-6989
- CareAdvance Inpatient Navigation GuideOpen a PDF
- CareAdvance Inpatient WebEx - 8.3MB
(click to download) - CareAdvance Outpatient Navigation GuideOpen a PDF
- CareAdvance Outpatient WebEx - 7.5MB
(click to download)
Medical Intake for Commercial and Medicare Products:
Call: 800-363-4658, or Fax: 877-203-9401
Safety Net Intake:
Call: 844-694-6411, or Fax: 844-279-7140
Concurrent review can be faxed to: 855-742-0126
- SafetyNet Fax Form for Inpatient Preauthorization RequestsOpen a PDF (Use Inpatient form for Observation Level of Service)
- SafetyNet Fax Form for Outpatient Preauthorization RequestsOpen a PDF
Call 1-800-363-4658
Once the preauthorization has been created, the call will be transferred to SNF Utilization Management for Clinical Review
Safety Net:
Medicaid, Child Health Plus, Essential Plan
Call 1-844-694-6411 or Fax 1-855-742-0127
Long Term Care Support Services (LTSS):
Call 1-844-694-6411 or Fax 1-844-620-7013
Online with CareAdvance Provider
For Medical Specialty Drug Unit, call: 1-800-306-0151, or fax: 1-800-306-0188.
- Preauthorization Requirements (For Commercial, Exchange, and Medicare)Open a PDF
- Drug Prior Authorization Fax forms
- CareAdvance Outpatient Navigation GuideOpen a PDF
- CareAdvance Outpatient WebEx - 7.5MB
(click to download) - CareAdvance Inpatient Navigation GuideOpen a PDF
- CareAdvance Inpatient WebEx - 8.3MB
(click to download) - CareAdvance Tip SheetOpen a PDF
Medicaid, Child Health Plus, Essential Plan
Online with CareAdvance Provider
or call 1-844-694-6411 or fax: 1-855-346-4418.
- Preauthorization Requirements (For Medicaid and Child Health Plus)Open a PDF
- Medicaid Managed Care-Medical Specialty Drugs (Health Professional Administered) Standard Authorization FormOpen a PDF
- CareAdvance Outpatient Navigation GuideOpen a PDF
- CareAdvance Outpatient WebEx - 7.5MB
(click to download) - CareAdvance Inpatient Navigation GuideOpen a PDF
- CareAdvance Inpatient WebEx - 8.3MB
(click to download) - CareAdvance Tip SheetOpen a PDF
Online through CoverMyMeds ePA Portal
Fax: Prior Authorization Fax Request Forms
Eform: Send Request via Secure Eform (sends to our FAX server)
Or, call the number on the Member's ID Card
Request Authorization Right Side Col Content 2
Request Authorization Right Side Col Content 1
Get Your Facets Provider ID
You'll need your Facets ID to use CareAdvance Provider.
Request Authorization Right Side Col Content 3
eviCore Healthcare Information
Get help with urgent/emergency requests, appeals process and help acessing eviCore online.
Learn more
Request Authorization - Modal for Facets ID
Modal for Get Your Facets Provider ID
Get Your Facets Provider ID
To recieve your Facets Provider ID you can either
- Call: 1-800-363-4658 or
- You can Email our Provider Help Desk
Behavioral Health Auth Forms Modal
Modal for Behavioral Health Fax and Request Forms
Behavioral Health Fax and Request Forms
- SafetyNet Fax Form for Inpatient Preauthorization RequestsOpen a PDF
- SafetyNet Fax Form for Outpatient Preauthorization RequestsOpen a PDF
- NeuroPsychological Testing Authorization Request FormOpen a PDF
Please use this form for Medicaid Managed Care and HARP (Blue Option Plus & Premier Option Plus) lines of business only - Outpatient Treatment Authorization Request FormOpen a PDF
- Adult Behavioral Health Home and Community Based Services (BH HCBS): Prior and/or Continuing Authorization Request FormOpen a PDF
Please include a completed HCBS Authorization Checklist along with the HCBS Prior and/or Continuing Authorization request form - HCBS Auth ChecklistOpen a PDF
GLO-PRV-Request Authorization-Clear Coverage Attestation Script
Script for showNoticeAttestation Function
