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Prior Authorization Lists and Forms

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. Services or items requiring an authorization are identified in the plan documents and listed here by plan. 

You Can Request an Authorization Electronically

Visit your provider portal, Provider Connect, to submit and track your authorizations online.

Request Rx Prior Authorization

Select medications may require prior authorization. A physician or member may request authorization.

Talk with our Provider Services representatives 

call us at 541-768-5207 1-888-435-2396 8 a.m. to 6 p.m.
Mon. - Fri.