Prior Authorization Information for Providers

MediGold requires prior authorization on select services. MediGold's Health Services department and delegated partners handle prior authorization for our valued providers. Please review all information below to find the correct information by year and area.

MediGold Prior Authorization List

2017 Prior Authorization Information For:

 

  • Bariatric surgery

  • BRACAnalysis®  Large Rearrangement Test (BART™)

  • Hospital admissions (medical, surgical, behavioral health and rehabilitation)

  • Hyperbaric oxygen chamber treatment

  • Out-of-network care (HMO members only)

  • Power mobility devices

  • Skilled nursing (notification only)

 

Request Forms

Please note: providers requesting power mobility devices must additionally complete the form below:

Power Mobility Device Questionnaire


2017 Prior Authorization Information

Effective January 1, 2017, providers must contact HealthHelp for prior authorization requests for:

  • Cardiology Services
  • Medical Oncology
  • Radiology
  • Radiation Oncology

MediGold will continue to prior authorize bariatric surgery, BRACAnalysis®  Large Rearrangement Test (BART), hospital admissions, hyperbaric oxygen chamber treatment, power mobility devices and skilled nursing (notification only).                 

Additional HealthHelp Information


         Part D Drugs

        Updated 03/2017