Prior Authorization

Abrazo Advantage Health Plan requires prior authorization for elective hospital admissions and certain acute outpatient services. Prior authorization is not required for emergency services. Questions about covered services, the status of a referral or the need for authorization should be directed to the Prior Authorization Department at
602-824-3760.

Requesting a Prior Authorization

1. Verify member eligibility prior to the provision of services.

2. Complete appropriate referral/authorization form (OB/GYN, Medical or Pharmacy) and attach supporting documentation.

3. Submit request via FAX or telephone

Fax number: 602.674.6678

Time Frames for Processing Requests

Urgent - An urgent request is appropriate for a non-life threatening condition, which if not treated promptly, will result in a worsened or more complicated patient condition. An urgent request will be responded to within three (3) working days upon receipt of request.

We encourage you to call the Prior Authorization Department for all urgent requests.

Routine - A routine request is a non-urgent request that will be responded to within 14 calendar days upon receipt of request.