5 tips for submitting prior authorization requests

What services require prior authorization? Where can I submit a request? How do I check the status of an authorization request? We hear these questions often. To help you access all the answers in one place, we’ve put together a list of helpful tips for providers and administrators. Continue reading to learn more about how to submit a prior authorization request with Mass General Brigham Health Plan.

Services that require prior authorization

If you need to look up a service that requires prior authorization, start by viewing the Prior Authorization, Notification, and Referral Guidelines. For member-specific information, log into the provider portal. You and your staff also can access our code checker tool. This allows you to search prior authorization requirements by code and member ID.

Register for the Provider portal to submit authorizations online

Administrative and clinical staff can use the provider portal to submit prior authorizations. Keep in mind that it takes about five minutes to register for the provider portal. It’s important to remember to have all necessary clinical information, like your practice’s tax ID number, available before you submit an authorization. Each practice has a user administrator who manages access requests. So, if you have questions about registering, start by contacting the user administrator at your practice. Register now.

Once registered, visit the provider portal to submit prior authorization requests. The below guides will walk you through submitting a request:

Providers not contracted directly with Mass General Brigham Health Plan

Even if you’re not contracted with Mass General Brigham Health Plan, you can still submit medical authorization requests. You can complete this online through the authorization request form. This includes:

  • UnitedHealthCare Options PPO providers
  • MultiPlan PHCS network providers
  • Out-of-network providers

Revise existing authorizations

You can request a revision via our provider portal. Once the request is submitted, the revisions will pend for additional review. InterQual Connect is only available for the initial prior authorization for outpatient services. We are working on adding this functionality in a later release.

Check the status of your authorization request

Providers can use our Authorization Look Up function to check the status of a request. Additionally, providers will be notified verbally and will receive denial letters via mail for any request that may be denied. For additional information and resources about prior authorizations, view the Mass General Brigham Health Plan Authorization guidelines page.

For more provider tips along with health and wellness education, follow @MGBHealthPlan on InstagramLinkedIn, and Facebook.


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