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Submit a Prior Authorization

FOR MEDICAL PROFESSIONAL USE ONLY

Prior Authorization Instructions

For Meridian Medicare-Medicaid Plan plan information on how to submit a prior authorization request, please refer to our new authorization lookup tool.

For pharmacy authorization requests, visit Pharmacy.

Meridian partners with several external entities to manage prior authorizations for certain services or populations. The following grid outlines all entities including the request submission options, applicable plans, and delegated services.

EntityType of ServiceRequest Submission OptionsMeridian
(Medicaid)
eviCore  Sleep Studies, Genetic Testing  Portal: http://www.evicore.com
Phone: 1-888-333-8641

Fax - PT/OT: 855-744-1319
Fax - All other services: 800-540-2406		X
National Imaging Associates, IncRadiology/Cardiology, Pain Management, Physical/Occupational Therapy

Portal: RadMD.com

Phone: 1-866-214-2493

X
HealthHelpMedical oncology, radiation therapyPortal: portal.healthhelp.com
Phone:1-888-285-0562
Fax: 866-203-7271		X
TurningPointMusculoskeletal surgical proceduresPortal: www.myturningpoint-healthcare.com

Phone: 1-877-659-3409
Fax: 773-819-2024
X
ProgenyHealthNICU admissions

Phone: 1-888-832-2006
Fax: 844-868-5054

X

Alternately, view Prior Authorization requirements, training tools, submission options and user guides online.

Updated Date: 10/01/24

H6080_WEBSITE_2025_Accepted_09302024


Updated Date: 10/01/24

H6080_WEBSITE_2025_Accepted_09302024

Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Meridian Member Handbook. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. You can get this document for free in other formats, such as large print, braille, or audio. Call 1-855-580-1689 (TTY: 711). Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.

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