Prior Authorization
Forms and resources for prior authorization
20 resources in this category
MRI Prior Authorization Request Guide
Guide to obtaining prior authorization for MRI scans including required clinical documentation and common approval criteria.
Surgery Prior Authorization Checklist
Comprehensive checklist of documentation needed for surgical prior authorization across major insurance carriers.
Specialty Drug Prior Authorization Guide
How to navigate the prior authorization process for specialty and biologic medications including supporting documentation.
CT Scan Prior Authorization Request Guide
Guide to obtaining prior authorization for CT scans with clinical justification templates and insurer-specific requirements.
PET Scan Prior Authorization Guide
How to get prior authorization approved for PET scans, including oncology staging and restaging indications.
Inpatient Admission Prior Authorization Guide
Guide to obtaining prior authorization for planned hospital admissions including InterQual and Milliman criteria.
Physical Therapy Prior Authorization Template
Template for requesting prior authorization for physical therapy sessions with functional assessment documentation.
Mental Health Treatment Prior Authorization Guide
Guide to prior authorization for mental health services including inpatient, residential, and intensive outpatient programs.
DME Prior Authorization Checklist
Checklist of documentation required for durable medical equipment prior authorization including letter of medical necessity.
Home Health Prior Authorization Guide
How to obtain prior authorization for home health services including skilled nursing, PT, OT, and home health aide hours.
Genetic Testing Prior Authorization Guide
Guide to prior authorization for genetic and genomic testing with clinical criteria and supporting evidence requirements.
Urgent Prior Authorization Request Template
Template for requesting expedited or urgent prior authorization when standard timelines would jeopardize patient health.
Peer-to-Peer Review Preparation Guide
How to prepare for a peer-to-peer review call with the insurance company's medical director after a prior auth denial.
Letter of Medical Necessity Template
Comprehensive template for physicians to write letters of medical necessity supporting prior authorization requests.
Prior Authorization Tracking Worksheet
Worksheet to track prior authorization submissions, reference numbers, deadlines, and follow-up actions.
Radiation Therapy Prior Authorization Guide
Guide to obtaining prior authorization for radiation therapy including IMRT, proton therapy, and stereotactic radiosurgery.
Knee Replacement Surgery Prior Auth Guide
Prior authorization guide for total and partial knee replacement surgery with required conservative treatment documentation.
Spinal Surgery Prior Authorization Guide
Guide to obtaining prior authorization for spinal surgeries including fusion, laminectomy, and disc replacement.
Bariatric Surgery Prior Authorization Guide
Prior authorization requirements for bariatric surgery including supervised diet documentation and psychological evaluation.
Sleep Study Prior Authorization Guide
How to obtain prior authorization for polysomnography and home sleep tests with clinical indication documentation.