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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.
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.
2019 Authorization Lists
2019 Authorization List - Performance and Oregon Standard Plans
2019 Authorization List - Everyday Choices Plans
2019 Authorization List - Momentum Plans
2018 Authorization Lists
(For plans with an effective date between 1/1/2018 and 12/31/2018. Verify a member’s effective date on provider portal, Provider Connect.)
2018 Samaritan Standard, Health & Well-Being, and New Performance Prior Authorization List
2018 Samaritan Everyday Choices Prior Authorization List
2018 Samaritan Momentum Authorization List
Forms
Request Rx Prior Authorization
Select medications may require prior authorization. A physician or member may request authorization.
Talk with our Provider Services representatives
Mon. - Fri.