Meridian- Prior Authorization Process Detail

May 29, 2019

There has been some confusion on the proper forms to send into Meridian for Prior Authorizations. At times, the form is sent to the incorrect fax number, which results in delays of getting the needed authorization approvals in a timely manner.  The Meridian Team must then route the form to the correct intended department, and this causes unneeded delay for the patient.

 

The link to Prior Authorization which is located on their website mhplan.com To access once you are in the  Meridian website, you choose the state and Line of Business, then there is in the drop down for “Provider Resources”. The appropriate form is the same for any LOB and the training tools; submission options and user guides are located at the top of the form.

 

PRIOR AUTHORIZATION INSTRUCTIONS

For pharmacy authorization requests, visit our Pharmacy Benefit Manager (PBM) website, MeridianRx. (This will open in a new window).

 

Requests for medical oncology and radiation therapy services should be routed through HealthHelp. A complete list of procedure codes requiring review by HealthHelp are available at portal.healthhelp.com/Meridian. Requests can be submitted through the HealthHelp website, by phone 888-285-0562, or fax 866-203-7271.

 

Requests for cardiology and radiology services should be routed through eviCore. A complete list of procedure codes requiring review through eviCore can be accessed here. Requests can be submitted to eviCore via the eviCore website, by phone at 888-333-8641, or by fax to 800-540-2406.

 

For training tools, submission options and user guides, click here.