Prior Authorizations to Be Eliminated for 17 Care Services and Supplies


In a move designed to relieve some of the administrative burdens experienced by medical practices within our network, CDPHP is removing the requirement for prior authorization for the following services and procedures, effective January 1, 2020:

The determination was made after a careful review of claims denial history, regulatory requirements, and medical records. With this latest change in our policies, CDPHP will have removed a total of 37 prior authorizations over the last three years.

Through December 31, 2019, our providers should continue to submit prior authorization requests for all services and procedures for which they are currently required and adhere to our resource coordination policies, as services are subject to retrospective review for medical necessity. Questions about the new changes or any of our policies may be directed to our provider services department.

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