Auth Request tool guide: Request authorizations online
When you log in to your Priority Health account as a participating provider, you can access the Auth Request tool to:
- Get immediate proof of authorizations automatically for many procedures
- See medical necessity criteria
- Verify authorization requirements and member eligibility/coverage
- Transfer medical records securely
- Check the status of pending authorizations anytime
Requesting an authorization
When logged in as a participating provider:
- Click the Request an authorization button on this page, or the link to the Auth Request tool at the bottom of most Provider Manual or Provider Center pages.
- Choose the requesting provider type, Hospital or Practitioner/Vendor.
- For Practitioner/Vendor requests, start typing a procedure name or CPT code in the Primary procedure field, then choose the procedure or code from the drop-down of matching services.
- Select a servicing Facility and a servicing Provider.
- Click the Go to GuidingCare or Go to eviCore button that appears.
- You'll be logged in to GuidingCare or to eviCore to request the authorization.
- Return to the "Requesting an authorization" page to request additional authorizations.
Checking authorization status
The authorizations you request will be listed in our Auth Inquiry tool, but you'll find more details if you use Auth Request to go to GuidingCare or eviCore to check an authorization status.
Authorizations available in Auth Request
See our Authorization reference list for a summary of what services require authorization under which plans. The auth request tool guide will direct you to the correct authorization tool based on the information entered.
Services not included
- Services from non-participating providers
- Drug authorizations not related to an inpatient stay or home infusions - use the drug auth request forms
- Medicare pre-service organization determinations (PSOD). Medicare pre-service organization determinations.The Centers for Medicare and Medicaid Services (CMS) rules require that all Part C (Medicare Advantage) plans - NOT providers - give a specific written notice to members if a service or item isn't covered. The process for getting this written notice of non-coverage from Priority Health is called requesting a pre-service organization determination (PSOD). Go to PSOD instructions
Resource and training materials
For eviCore: Go to the training materials page.
For GuidingCare: Go to the training materials page.