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Authorizations
 
Utilization Management decision making is based only on appropriateness of care and service and existence of coverage.  The Foundation does not specifically reward practitioners or other individuals for issuing denials of coverage or services.  The Foundation does not offer financial incentives to UM decision makers that encourage decisions that result in underutilization.
Read the Foundation Utilization Management Policy & Procedures
 
  • What services need prior authorization?
    • All out of area and/or out of network services require prior authorization.
    • Click here to search by CPT code or procedure description.
  • Want to check Authorization Request Status?
    • Click here to login to our web services.
  • Need an authorization form?
    • Click here to view our on-line forms library.