Home|Providers|Authorizations Authorizations Page Image Page ContentCertain specialized services and prescription drugs require a prior authorization or inpatient notification before being rendered to patients and members. Prior authorizations and inpatient notifications ensure that patients are receiving the right amount of medically necessary care in the right setting for the insurance plan for which they're enrolled.Medical Prior Authorization Guide Intel Connected Care Prior Authorization Grid Prior Authorization Request Form Centennial Care Prior Authorization Request Form Durable Medical Equipment (DME) Prior Authorization Request Form Referral Form: Care Coordination/Case Management/Disease Management Criteria for Total Hip Replacement (Checklist) Criteria for Total Knee Replacement (Checklist)Home Healthcare Prior Authorization Form Pharmacy A list of drugs that have specific edits/requirements for coverage Specialty Pharmaceuticals/Medical Drugs List Pharmacy Prior Authorization Form How to Submit a Prior Authorization Online Synagis Prior Authorization Form Systemic Estrogen Prior Authorization Form for Medicare Suboxone/Subutex Prior Authorization Form for Commercial and Medicare Plans Fax completed Prior Authorization forms to Presbyterian Pharmacy Services at (505) 923-5540 or 1-800-724-6953.- OR - Complete and submit Prior Authorization onlineAdvanced Imaging Ordering ProgramPresbyterian uses the Medical Specialty Solutions (MSS) program, managed by National Imaging Associates, Inc. (NIA), for prior authorizations of both non-emergent, advanced diagnostic imaging procedures and cardiac-related imaging procedures performed in an outpatient setting. The program is designed to streamline the authorization process, reduce healthcare costs, and improve patient outcomes. The documents below provide additional information about the MSS program. If you have any questions or concerns about the program, please contact your Provider Network Management relationship executive. General Announcement General Frequently Asked Questions (FAQs) Quick Reference Guide Utilization Review Matrix Announcement for Cardiac Providers Cardiac-Related Frequently Asked Questions (FAQs) Checklist for Cardiac Providers Submit a prior authorization to the MSS program Behavioral Health Centennial Care Behavioral Health Prior Authorization Grid Centennial Care Concurrent Clinical Review Form Centennial Care Discharge Clinical Notification Form Centennial Care Initial Clinical Review Form Centennial Care Retrospective Clinical Review Form Applied Behavior Analysis (ABA) Clinical Review Form: Stage 3 Applied Behavior Analysis (ABA) Specialty Care Clinical Review FormNeed Assistance?For assistance with Prior Authorization or Utilization Management issues please call 505-923-5757 or 1-888-923-5757. We may be reached using this number both during and after normal business hours. Additional Content Back To Top Sidebar Content Chaplaincy ServicesWe provide ministry and emotional support for patients and their families and support for healthcare workers in times of crisis. Let us help.Learn More.Presbyterian Health Plan News & UpdatesFind out about the newest staff and the latest technology, and all the other happenings at Presbyterian.Learn More.