Prior Authorizations

Prior authorization is the process used to authorize designated medically necessary services. The majority of services do not require authorization.

The primary care office submits the prior authorization request, which provides the medical information related to the services requested.

The request is reviewed, and is authorized (approved) or denied. An authorization number is issued when a request is authorized.

MAP Authorization Form: See documents entitled:

• Prior Authorization Form
• Polysomnography — Sleep Study Authorization Form
• “Varicose Vein Referral (Coverage Guidelines)”

Please visit www.setonhealthplan.com/providers/ for the latest version.