Participating providers

• Behavioral Health

• Fax all requests for services that require precertification to:
  Inpatient 1-877-434-7578
  Outpatient1-800-505-1193

• The following markets may fax Behavioral Health Outpatient Requests to the specified fax line below to meet turnaround time (TAT) requirements: Iowa and Texas.
  Outpatient 1-866-877-5229

• Services billed with the following revenue codes ALWAYS require precertification:

• 0240–0249 — All-inclusive ancillary psychiatric
• 0901, 0905–0907, 0913, 0917 — Behavioral health treatment services
• 0944–0945 — Other therapeutic services
• 0961 — Psychiatric professional fees

• Pharmacy

  Check our preferred drug list by product and state

• Services billed with the following revenue codes ALWAYS require precertification:

• 0632 — Pharmacy multiple sources

• Medicare/Long-Term Services and Supports

  For state-specific precertification requirements choose your state:

  Florida
  Georgia
  Kansas
  
  Maryland
  New Jersey
  Tennessee
  Texas Washington

• The following ALWAYS require precertification:

  • Elective services provided by or arranged at nonparticipating facilities

  All services billed with the following revenue codes:

  • 0023 — Home health prospective payment system
  • 0570–0572, 0579 — Home health aide
  • 0944–0945 — Other therapeutic services
  • 3101–3109 — Adult day and foster care