Change an existing medical authorization

In some situations, you may need to make a change to an open existing medical authorization. To help you through the process, refer to the sections below. Note: No changes can be made to a decisioned/closed/voided auth.

Participating providers (in-network)

The following requests for changes can be made through secure email:

  • Changing date of service
  • Changing provider or facility
  • Changing a diagnosis code

*Changing or adding procedure codes requires a new authorization.

  1. Log in and use your Secure Mailbox to begin composing your message and select from the drop-down menu:
  • Pre-Service authorization change: All outpatient, DME, home health and inpatient elective procedures. *Changes can only be made before the supply or service is provided. Refer to the Retrospective authorizations page in the Provider Manual
  • Inpatient authorization change: Urgent and emergent inpatient admissions only
  • Post-acute authorization change: Facility admissions including SNF, LTACH and IPR
  1. In your message include the following:
  • Member name
  • Date of birth
  • ID number
  • Authorization number
  • Change being requested

Go to your Mailbox. If you're unsure of how to use your secure mailbox, see our tool guide for additional information.

Non-participating providers (out-of-network)

Fax the medical authorization form with the following information:

  • Member name
  • Date of birth 
  • ID number
  • Authorization number
  • Change being requested

Access the Medical/service/device authorization forms here.

Fax numbers

  • Inpatient: 616.975.8858
  • Post-acute inpatient: 616.975.8848
  • Pre-service/outpatient: 888.647.6152

Drug authorization changes

Drug prior authorization forms


To make any changes to an eviCore authorization, including high-tech imaging or lab and genetic services, contact eviCore Client Services at 844.303.8456.