Pre-authorization

Commercial

Group and individual product pre-authorization and notification requirements.

Uniform Medical Plan

View pre-authorization and notification requirements for the Uniform Medical Plan (UMP).

Medicare

Our Medicare Advantage pre-authorization and notification requirements.

Pharmacy

Pharmacy pre-authorization and medication information.

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Utilization management delegation

At times, Regence will make a business decision to delegate utilization management activities to vendors or provider groups that have demonstrated an ability to manage those services. Regence actively oversees these delegated activities through reporting, auditing and annual reviews. If you have questions about our Utilization Management Delegation Program, please contact your Provider Services representative.

Electronic authorizations

Use Availity's electronic authorization tool to determine whether pre-authorization is required for a medical service and to submit your medical pre-authorization requests. There's no need to call or fax us; login to the Availity Provider Portal to inquire and submit a request. It's quicker and more convenient for you.

Learn more