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Standardized prior request form

Amerihealth authorization request 2025

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The document is a Standardized Prior Authorization Request Form that outlines the necessary information and procedures for submitting a prior authorization request for various medical services. It emphasizes the importance of completing all sections and providing supporting documentation to avoid delays or dismissals. The form includes sections for member information, requesting provider details, servicing provider information, and specific service types requiring authorization. Additionally, it provides contact information for assistance and highlights confidentiality and eligibility requirements.

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Click ‘Get Form’ to open the amerihealth authorization request in the editor.
Begin by selecting whether your request is 'Urgent' or 'Standard' at the top of the form.
In the 'Service Type Requiring Authorization' section, check all applicable services such as Ambulatory/Outpatient Services, Pharmacy, Inpatient Care, and more.
Fill in the required Member Information fields marked with an asterisk (*), including Member ID, Last Name, First Name, and Date of Birth.
Complete the Requesting Provider Information section by entering your NPI, TIN, contact information, and fax number.
Provide Servicing Provider/Facility Information. Choose between Participating or Non-participating providers and fill in their details accordingly.
In the Authorization Request section, enter all required procedure codes, diagnosis codes, dates, total units/visits/days, and any additional comments.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Does Amerihealth Caritas require authorization?

Prior authorization is required for all services provided by non-participating physicians and providers, with the exception of emergency services.

What is a medical authorization request?

Prior authorization is a way for insurance companies to review the medical service, procedure, item, or medication requested and make sure that its necessary for your care. Examples of services or procedures for which prior authorization may be needed include: admission to a hospital or skilled nursing facility.

How do I get insurance authorization?

The patient or their representative can contact their insurance company and provide the relevant information to start the Prior Authorization process. Its best to confirm with the healthcare provider if they have the information and are willing to submit the request.

What are authorization requests?

Authorization request processes may have different details, but they generally include similar steps: someone requests for something to be authorized, someone with approving authority considers the request, and then grants or denies it.

What does medical authorization mean?

Prior Authorizations Under medical and prescription drug plans, some treatments and medications may need approval from your health insurance carrier before you receive care. Prior authorization is usually required if you need a complex treatment or prescription. Coverage will not happen without it.

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Why is my insurance asking for a prior authorization?

Insurance providers use prior authorization to make sure that a specific medical service is needed and worth the cost, and that no duplicative services are being performed. Payers use prior authorization as a way to keep healthcare costs in check.

What is the phone number for Amerihealth authorization?

Prior authorization is required to see out-of-network providers, with the exception of emergency services. To submit a request for prior authorization providers may: Call the prior authorization line at 1-833-637-3386 (*for behavioral health requests call 1-833-727-3301);