Change an existing medical authorization
The following requests for changes can be made to existing Priority Health pending or approved medical authorizations. (For eviCore authorizations, call eviCore Client Services at 844.303.8456.)
- Change in date of service or DME rentals
- Change in units, visits or days
- Change provider or facility
- Request to void a pending or an approved authorization
Limits to changing an existing medical authorization:
- Adding or updating procedure or diagnosis codes requires a new authorization
- No changes can be made to a denied or voided authorization
- If you'd like to withdraw a pending authorization, use GuidingCare to request authorization withdraw
How to change your authorization request
Participating providers (in-network) and Non-participating providers (out-of-network) with a prism account
- Log into prism
- Click the General Requests tab
- Select New Request
- On the next screen, select the appropriate Authorization Change based on your request
- Scroll down to the bottom of the box to select Next
- Follow the prompts to submit your request.
You'll see your request and responses within prism on the General Requests page.
Watch our video tutorial on submitting General Requests for a walk-through of this process. Follow the link below and scroll to the bottom.
Non-participating providers (out-of-network) without a prism account
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.
- Inpatient: 616.975.8858
- Post-acute inpatient: 616.975.8848
- Pre-service/outpatient: 888.647.6152
Drug authorization changes
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.
- Urgent/emergent authorizations
- Change an existing auth
- Check an authorization status
- Behavioral health authorizations
- Medical auth forms
- Medical necessity criteria
- Medical policies
- Medicare pre-service notices
- Retrospective auths
Create a prism account
Get access to our online member eligibility, authorizations and claims tools.