COVID-19 UPDATE: Please note that some Prior Authorization guidelines have been modified to accommodate the challenges faced during the public health emergency of COVID-19 and may not be reflected in this tool. Please visit the COVID-19 Provider Page for details.
DISCLAIMER: The requesting provider is responsible for verifying the member’s eligibility and benefits on the date of service. Prior Authorization requirements apply to all In-Network and Out-of-Network Providers. Alliant Health Plans may need to assist in returning the Member to an In-Network Provider when it is medically safe.
Please note: All attempts are made to provide the most current information on the Prior Authorization Search Tool. However, this does NOT guarantee payment. The Prior Authorization Search Tool is limited to only the codes and information provided by the provider on the date of the request and a determination of Prior Authorization applicability may change. Codes utilized for Prior Authorization purposes may be amended, from time to time, based upon Center for Medicare and Medicaid Services' (CMS) approval, removal, or rejection of applicable codes. Payment of claims is dependent upon eligibility, covered benefits, provider contracts, correct coding and billing practices and the medical record documentation to support the Medical Necessity of a Covered Service. For information on specific payment requirements, please refer to the provider manual. If you are uncertain that a Prior Authorization is needed, or to request a Prior Authorization, please call (800) 865-5922 or fax a completed Prior Authorization Request Form to (866) 370-5667.
For specialty pharmacy medication administered in any setting other than inpatient, contact Magellan Rx, Alliant Health Plan’s Pharmacy Benefit Manager, at
If you have additional questions, please contact Customer Service at (800) 811-4793.
Note: Services provided by Out-of-Network Providers are still subject to Medical Necessity review but are paid at an Out-of-Network benefit level.