Now you can submit prior authorization requests online any time

Can you say convenience? That’s what you get with Pennsylvania’s new online process for submitting prior authorization requests.

Behavioral health providers must now use the standard Pennsylvania online prior authorization form when requesting authorization of services. This applies for members covered by Pennsylvania issued commercial  fully insured health plans for all levels of care and Pennsylvania CHIP plans. *  The  standardized form is required to be available for use under Pennsylvania Senate Bill 225.

What you need to do

Follow these steps if requesting prior authorization for all levels of care except for inpatient, residential or partial hospitalization:

1. Access the Pennsylvania Prior Authorization Electronic Submission form on Providerexpress.com
2. Complete the form – be sure to fill in all fields marked mandatory
3. Submit the form – you should see a confirmation page after the successful completion

Steps for network providers with a Provider Express One Healthcare ID requesting authorization for inpatient, residential or partial hospitalization:

1. Log into the Provider Express secure portal
2. Select Auth Option from the menu
3. Choose Review Online
4. Complete the request

Need more info?

You may call the number on the back of the member’s ID card.

*Submitting the online prior authorization form doesn’t guarantee authorization of your request. Use of the form is required for all authorization requests submitted on or after July 1, 2024.