Presbyterian

Providers

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Home|Providers|Authorizations

Authorizations

Certain specialized services and prescription drugs require a prior authorization before being rendered to patients and members. Prior authorizations ensure that patients are receiving the right amount of medically necessary care in the right setting for the insurance plan they’re enrolled in.

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)

Pharmacy

Advanced Imaging Ordering Program

The documents below provide additional information about the Radiology Utilization and Cost program. If you have questions or concerns about the program, please contact your Provider Network Management Relationship Executive.

For information about the company, see HealthHelp

Behavioral Health