Health insurance can be complicated—especially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). We’ve provided the following resources to help you understand Anthem’s prior authorization process and obtain authorization for your patients when it’s required.
Prior Authorization Code Lists
Use these lists to identify the member services that require prior authorization.
Federal Employee Program (FEP) Precertification Requirements
Use this list to identify the inpatient and outpatient services that require prior approval under FEP Standard, Basic and/or Blue Focus plans.
Interactive Care Reviewer is a utilization management tool that lets you submit prior authorization requests and other clinical information quickly and easily.