Skip to Main Content

Medicaid Pre-Auth

DISCLAIMER: Your current browser's security settings does not allow the use of this tool. This tool requires the use of Internet Explorer 10 or Later. If you are currently using Internet Explorer as your browser and you see this message, you should try to update it or use another browser like Google Chrome or Firefox.
DISCLAIMER:

All attempts are made to provide the most current information on the Pre-Auth Needed Tool. However, this does NOT guarantee payment. Payment of claims is dependent on eligibility, covered benefits, provider contracts, correct coding and billing practices. For specific details, please refer to the provider manual. If you are uncertain that prior authorization is needed, please submit a request for an accurate response

Are Services being performed in the Emergency Department or Urgent Care Center or Family Planning services billed with a Contraceptive Management diagnosis?

Types of Services YES NO
Is the member being admitted to an inpatient facility?
Are services being rendered for pain management?
Are anesthesia services being rendered for dental procedures?
Are oral surgery services being provided in the office?
Are services, other than DME, orthotics, prosthetics, supplies, home infusion, physical therapy, occupational therapy, speech therapy, being rendered in the home?
Is the member receiving hospice services?
Are services being rendered by a Chiropractor?