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Authorizations
The Utilization Management team manages authorization requests made on behalf of our members. This includes medical, surgical, mental health and addiction medicine requests for inpatient, rehabilitation, DME and other specialty services requiring an authorization for the plan.
Samaritan Health Plans will not review any retroactive requests for medical necessity unless the request meets certain exceptions outlined in our Prior Authorization FAQ.
IHN-CCO Utilization Management & Service Authorization Handbook
Utilization management (UM) is integrated within the Medical Management care management program. This handbook is designed to assist in understanding the prior authorization review process: types of reviews performed, specific criteria applied, notification process, etc. Please access this handbook for more information and step-by-step instructions for submitting online prior authorization requests. Utilization Management & Service Authorization Handbook
Request an Authorization Electronically
Visit your provider portal to submit and track your authorizations online.
Prior Authorization Lists and Forms
Services or items requiring an authorization are identified in the plan documents and listed here by plan.
2021 Authorization Lists
2021 Authorization List - Performance and Oregon Standard Plans
2021 Authorization List - Everyday Choices and Momentum Plans
2020 Authorization Lists
2020 Authorization List - Performance and Oregon Standard Plans
2020 Authorization List - Everyday Choices
2020 Authorization List - Momentum Plans
2019 Authorization Lists
2019 Authorization List - Performance and Oregon Standard Plans
2019 Authorization List - Everyday Choices Plans
2019 Authorization List - Momentum Plans
Forms
Request Rx Prior Authorization
Select medications may require prior authorization. A physician or member may request authorization.