Prior Authorization

Prior authorizations

Information about prior authorization processing timeframes and incomplete prior authorization requests can be located in the Prior Authorization Requirements document linked below.

Manage prior authorizations in the provider portal

Recently, we made some changes to our authorization process. You may have noticed that the Authorization button in the menu bar is now active. Clicking on the Authorization button in the provider portal will take you to a new screen to submit and manage prior authorizations.

  • Access the provider portal to submit or manage prior authorizations at
    • Sign on to the provider portal.
      • Users of the portal must be tied to a provider TIN or re-register for portal access.
  • To access prior authorizations, click “Authorizations” on the top menu bar to be taken to the prior authorization portal within the provider portal.

In the prior authorization portal, you can:

  • Submit a new authorization request
  • View requests for your patients
  • View an interactive dashboard showing the status of all new prior authorizations
  • Search for an existing authorization
  • Communicate directly with the Utilization Management team

Watch the training video to learn how to manage prior authorizations for medical, surgical and behavioral health inpatient and outpatient services in the portal.

For questions, call Provider Customer Services at 1-844-781-2343. Staff are available Monday through Friday from 8 a.m. to 5 p.m. Central time. Documentation and forms required for prior authorization requests are available on our provider portal through the Dell Children’s Health Plan.

Member assistance with prior authorizations

Members who have questions regarding prior authorizations may contact Member Services at 1-855-921-6284 (TTY 711), available Monday through Friday from 8 a.m. to 6 p.m. Central time.

After hours locations

You can also view a list of urgent care and after hours locations here.

Urgent care centers

You can also view a list of urgent care and after hours locations here.