We have seen an increase in claims from out-of-network providers because of improper referrals from in-network doctors. These out-of-network referrals may cost your patients higher, and possibly unexpected, out-of-network charges.
If you have to refer your patients to an out-of-network provider in non-emergency situations, you will need to get preauthorization approval from us first. In emergencies, you can refer patients to out-of-network providers without getting our permission first.
To get our prior approval for out-of-network referrals, simply fill out this preauthorization form and fax it, along with any supporting medical documentation, to our clinical review team at 1-800-923-2882 or 1-860-674-5893.
Please note, services are not considered authorized until we issue an authorization. Incomplete or missing information will delay the processing of the preauthorization request.