Prior Authorization Guidelines
for NHP plans and members.
At your fingertips: Below please find our Prior Authorization Guidelines for all services that customarily require prior authorization and/or notification.
Limited benefit information has been included when this information is necessary to support a prior authorization, notification, or referral requirement.
Sleep Management Program
Sleep study requests and authorizations, as well as CPAP equipment, may be obtained by visiting the Sleep Management Solutions website.
Utilization Management Programs through eviCore Healthcare
UM Programs Requiring Authorization (Link to Prior Authorization Code PDFs)
Authorizations can be requested through eviCore Healthcare
Phone: 1-888-693-3211 (toll-free), 8 AM to 9 PM ET
Cardiology, Ultrasound, High-Tech Radiology Imaging
Lab Management (Molecular & Genetic Testing)