GLO-PRV-Authorization-Clear Coverage-Hide Clear Coverage app and remove links

The NYS Executive Order #4Open a PDF has been extended to June 29, 2022. We will suspend preauthorization requirements for dates of service September 27, 2021 – June 29, 2022 for scheduled hospital surgeries and admissions, hospital outpatient services, home health care services following a hospital admission and inpatient and outpatient rehabilitation services following a hospital admission for fully insured members and self-insured groups that have opted in. Submission of the completed state-approved certification formOpen a PDF is required. Please continue to notify us of all inpatient admissions and discharges to ensure continuity and coordination of care.

CareAdvance Expedited Requests: If an authorization is an expedited request, the provider must call Medical Intake with a case number to expedite.

Request Authorization

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


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
Concurrent review can be submitted via SDS Provider Portal

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

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For questions, please contact your Provider Relations Representative

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