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.
State Health Benefit Plan Information
Please note that CVS Caremark administers the pharmacy benefits for the State Health Benefit Plan. Contact CVS Caremark by phone at 844-345-3241 or visit their website.
Please note that IngenioRx is the pharmacy benefits manager for Medicare Advantage plans. The IngenioRx member services telephone number is 833-279-0458.
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.
