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Preauthorization updates for 2020

12/03/2019

We regularly review our medical preauthorization policies to make sure members have access to cost-effective, quality health care. We are updating those policies for dates of service on and after Jan. 1, 2020, for both our commercial and Medicare Advantage plans.

The updates are:

  1. Medicare Advantage plans: We are adding services — including orthopedic services, foot surgery and hysterectomy — to our preauthorization list for 2020. Please refer to this Medicare Advantage preauthorization list for details on codes.
  2. Commercial plans: We are adding services — including orthopedic services, foot surgery and hysterectomy — to our preauthorization list for 2020. Please refer to this commercial preauthorization list for details on codes for members with individual and employer-sponsored commercial plans.

How to submit preauthorization requests
Preauthorization requests will be reviewed by us or our partners, depending on the service. The preauthorization lists will direct you to the right resource for preauthorization review. You can help avoid delays by including all supporting clinical patient information with your preauthorization requests.

Our Call Center is currently experiencing extremely high volume and longer wait times. For questions related to COVID-19, visit our COVID-19 FAQs