Utilization Management
Information about prior authorizations.
Utilization Management reviews prospective, concurrent and retrospective services to determine medical necessity, appropriateness, and reasonableness for our members. Our goal is to ensure quality services and patient outcomes in a cost efficient manner. Our nurses are locally based and have a robust knowledge of the community and the healthcare services available and are here to help you with your healthcare needs. Below is a list of items that commonly require authorization.
Prior Authorization Requirements
Pre certification may be required for the following. Please contact Medical Associates Health Plans at 1-866-821-1365 or 563-584-4885 for plan specific requirements:
2024
Medicare Prior Authorization List
Commercial Prior Authorization List
If you are a member and need help finding the appropriate provider, determining if your medical care needs authorization, or regarding another health care concern, you can contact Health Care Services at 563-584-4885 or toll free 1-866-821-1365.
If you are a provider, you may call Health Care Services at 563-584-4885 or toll free 866-821-1365 to inquire about the authorization process or to help navigate a member’s healthcare needs. Medical Associates Health Plans and Health Choices utilizes My eLink, a portal to submit electronic requests, for authorizations. If you are not able to utilize My eLink, you may fill out and send in the prior authorizations forms.
Prior Authorization Electronic Request
