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Prior Authorization & Claims

Prior Authorization Lookup

If the member’s independent practice association (IPA) is delegated for utilization management, please contact the IPA for authorization.

24/7 NurseLine

Phone: 1-800-224-0336, 1-800-368-4424 (TTY)
24/7

Physical Health

Authorizations, admission notifications and utilization management

Phone: 1-888-831-2246, option 3
Urgent care discharge: 1-805-713-0845
Fax (medical intake): 1-800-754-4708
Fax (inpatient and outpatient services): 1-866-333-4826
Monday to Friday, 7 a.m. to 5 p.m. PT

Access to care

Phone: 1-888-831-2246, option 3

Behavioral health (BH)

BH utilization management intake line — clinical and nonclinical assistance
Intake line: 1-888-831-2246, option 1, then option 2
Fax: 1-855-473-7902
Monday to Friday, 7 a.m. to 5 p.m.

Pharmacy

To submit a pharmacy prior authorization request, contact the Pharmacy department:
Phone: 1-866-363-4126
Fax: 1-844-512-7029
California Preferred Drug List

Transportation

LogistiCare: 1-877-931-4755

Click select to view code requirements

No Procedure Found.

To refine your search, consider the following:

  • Enter a valid 5-digit code for best results
  • If you are searching by code description, limit your search to a single term for more matches
  • The code you are searching for may be invalid or expired. Such procedures are not available for authorization and will be denied.
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