We require prior authorization for certain services and procedures. In these cases, providers will submit clinical documentation and medical records demonstrating that the service or procedure is medically necessary.
How to request an authorization
Submit authorizations through our Authorizations Request tool. Turnaround times vary by plan requirements, but in all cases are 7 days or less.
Authorization training & resources
Find provider training guides, FAQs and helpful resources for the three portals that are part of our Authorization Request tool – GudingCare, EviCore and TurningPoint:
Exceptions
Use the forms linked below to request authorizations for the following procedures until Aug. 31, 2026. Starting Sept. 1, 2026, requests for these procedures should be submitted through our Provider Portal.
- Solid organ transplant prior authorization form
- Bone marrow/stem cell transplant prior authorization form
- NICU/sick newborn prior authorization form
About our Authorization Request tool
Our Authorization Request tool has three portals – GuidingCare, EviCore and TurningPoint. The tool will automatically select the correct portal based on your authorization type:
GuidingCare authorization types
- Post-acute facilities
- Behavioral health
- Durable medical equipment (DME)
- Inpatient
- Outpatient
- Home health care
- Planned surgeries and procedures
EviCore authorization types
- High-tech imaging
- Lab and genetic services
- Radiation oncology
TurningPoint authorization types
- Cardiology
- MSK, spine and joint surgery
Services not included in our Authorization Request tool
- Drug authorizations not related to an inpatient stay or home infusions. Use our drug authorization request forms.
- Medicare non-coverage notices
- Services not covered by our plans