Prior Authorization

Phoenix Health Plan requires prior authorization for elective hospital admissions and certain acute outpatient services. Prior authorization is not required for emergency services. Questions about covered services and the status of an authorization should be directed to the Prior Authorization department.

Requesting a Prior Authorization
You will need to:

Verify member eligibility prior to the provision of services.
Complete appropriate referral/authorization form (OB/GYN, Medical or Pharmacy) and attach supporting documentation.

You may request a prior authorization by fax:
Fax number: 602.674.6678

Time Frames for Processing Requests

Routine - A routine request is a non-urgent request that will be responded to within 14 calendar days upon receipt of request. You may request a prior authorization by faxing the request with supporting documentation to fax number: 602.674.6678.
Expedited- Expedited requests will be processed within 3 days of receipt of all supporting documentation. An expedited request is made if "using the standard time frame could seriously jeopardize the member's life or health or ability to attain, maintain or regain maximum functionality."

You may call the Prior Authorization Department for all expedited requests at (602) 824-3700.

Prior Authorization Guidelines.pdf

Pharmacy Prior Authorization Form

Transplant Prior Authorization Instructions and Request Form

OB Prior Authorization

Prior Authorizatoin Form