Submit a Prior Authorization
FOR MEDICAL PROFESSIONAL USE ONLY
Prior Authorization Instructions
Prior authorization (PA) is required before certain services are rendered to confirm medical necessity. No PA is required for emergency or transportation services. All services for out-of-network providers, except emergency services, require prior authorization. Criteria utilized in decision making can be accessed through the secure provider portalExternal Link.
How to Request a Prior Authorization
- Determine if a PA is needed with the Meridian Prior Auth Check tool.
- Submit PAs electronically through the secure provider portalExternal Link for the most convenient service.
- First-time users: Create a new portal accountExternal Link for 24/7 access to patient lists, health information, and plan eligibility & the ability to submit and check the status of claims and authorizations.
Vendor Solutions | Vendor Links |
---|---|
Dental | Envolve DentalExternal Link |
MRA, MRI, PET, CT Scans, and Cardiac Imaging | EvolentExternal Link |
Pain Management | EvolentExternal Link |
Speech, Occupational and Physical Therapy | EvolentExternal Link |
Musculoskeletal Services | EvolentExternal Link |
Non-Emergent Non-Ambulance Transportation | MTMExternal Link |