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EXC - PRV - EPA Outage - temp

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

  1. Check the patient's benefits & coverage for plan-specific requirements.
  2. Submit your request below:

Nested Applications

Request Authorization Accordion (new)

 


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

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

Commercial & Medicare:

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

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New to CareAdvance Provider?

CareAdvance FAQ Open a PDF

Request Authorization Right Side Col Content 1

Get Your Facets Provider ID

You'll need your Facets ID to use CareAdvance Provider.

How to get your ID

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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

Behavioral Health Auth Forms Modal

Modal for Behavioral Health Fax and Request Forms

GLO-PRV-Request Authorization-Clear Coverage Attestation Script

Script for showNoticeAttestation Function