Prior Authorizations (also referred to as pre-approval, pre-authorization and pre-certification) can be submitted digitally via the authorizaton application in Availity Essentials.
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 CarelonRx is the pharmacy benefits manager for Medicare Advantage plans. The CarelonRx member services telephone number is 833-279-0458.
Submit for medical or behavioral health inpatient or outpatient services. Tract authorization cases. Access the Authorization application from the Patient Registration tab in Availity Essentials.
