Home > Washington Added Choice > Member Information > Prior Authorization Approval

Prior Authorization Approval

Some services ordered by KP Select Providers, PPO Providers, and Non-Participating Providers require prior authorization in order to be covered.

What requires prior authorization?

KP Select Providers

For care with KP Select Providers, your provider will obtain prior authorization, if required, for certain services.

PPO Providers

Certain drugs filled at MedImpact pharmacies may be subject to prior authorization. For a list of drugs requiring prior authorization, please click on this MedImpact Standard Commercial Drug Formulary.

First Choice Health or First Health Network

Some services, such as inpatient care (for example, hospital surgical procedures) and some outpatient procedures, require prior authorization to be covered.

How do I receive prior authorization?

Your PPO Provider will obtain prior authorization for you.
To learn more, review the prior authorization section in your Evidence of Coverage (EOC) for details.

Non-participating Providers

Any other licensed provider or physician

For Non-Participating Providers, some services, such as inpatient care (for example, hospital surgical procedures) and some outpatient procedures, require prior authorization to be covered.

How do I receive prior authorization?

Your Non-Participating Provider may obtain prior authorization for you or your authorized representative by calling 1-855-281-1840 (TTY 711).
If you don’t obtain prior authorization for services in the Non-Participating Provider network, you may have to pay the entire expense.
To learn more, review the prior authorization section in your Evidence of Coverage (EOC) for details.

Need prior authorization or have questions about it?

Call 1-855-281-1840 (TTY 711).