Getting Preauthorization
Online Form Resource Center
You can quickly and easily request preauthorization online by using our secure Form Resource Center. Our web-based application is available to all providers, whether or not they're in our network, 24 hours a day.
Preauthorization Process
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Member eligibility: Determine if the member is eligible for benefits under his or her health plan.
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Covered benefit: Determine if the service is a covered benefit under the health plan. If so, determine if benefits are still available.
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Prior approval: Determine whether the health plan requires prior approval for the service.
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Request preauthorization: If the health plan requires it for the service request preauthorization online through our Form Resource Center. Otherwise, the health plan will not cover the service.
Preauthorization FAQs
What is preauthorization?
Preauthorization is the process of requesting authorization for services before you give them.
How do I know if I need to request preauthorization?
You can contact the health plan to get benefit and eligibility information. If you have created a profile, you may also get this information on our health plan partners’ online provider resource tool.
How do I request a preauthorization?
CBA accepts preauthorization requests via the web, fax and phone.
Online
You can request preauthorization online through our secure Form Resource Center. All providers can use this tool whether or not they are in our network. CBA gives priority processing to requests submitted through the Form Resource Center. For more information, please refer to this quick reference guide.
If you have a profile to use our health plan partners’ online provider resource tool, you can instantly get your preauthorization any time of day. Here you will be able to check eligibility, benefits and preauthorization requirements. It's available to you 24 hours a day. (This tool does not apply for members of the Federal Employee Program or PAI plans.)
Fax
To request preauthorization by fax, please complete the appropriate preauthorization request form. If you fax your request to CBA, keep a copy of the faxed confirmation for your records.
Fax: 803-714-6456
Phone
To make a request by phone, please contact CBA during our regular business hours. To avoid delays, please have the member’s health plan information available and select the appropriate prompts.
Phone: 800-868-1032
How do you process a preauthorization?
Once we receive the request for preauthorization, our clinical staff begins processing the request. Here are the steps we use:
- Verify member eligibility, benefits, exclusions, parity, etc.
- Verify provider status (contracting/non-contracting).
- Confirm necessary demographic and clinical information to process the preauthorization.
- Generate certification if services are approved.
- Communicate the certification status and information to the provider.
How will I receive the authorization?
After we process your request, we will give case-specific information to both you and the member. We will respond using the same method you used to submit the request.