Regence preauthorization 2025

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The Prior Authorization Process Flow The healthcare provider must check a health plans policy or prescription to see if Prior Authorization is needed for the prescribed treatment. The healthcare professional must sign a Prior Authorization request form to verify the medical necessity claim.
Typical Time Frames for Prior Authorization Emergency Requests: If the medicine is urgently needed, insurance companies might speed things up and decide within a day. Complicated Situations: For special medicines or cases needing more info, it can take a few days to over a week.
Prior authorizationsometimes called preauthorization or precertificationis a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
To submit a requestion, your doctor may complete the Prior Authorization Request form and fax it to (888) 697-8122. If you are unsure whether the process has begun, contact your doctors office directly to confirm a prior authorization request was submitted.