How to Prior Authorize

All requests for certification are to be made by the Member or their practitioner’s office at least three (3) working days prior to the scheduled admission or requested service. In the event that health care services need to be provided within less than three (3) working days, contact the Utilization Management Department to request an expedited review. To prior authorize a service, please call our Utilization Management Department between the hours of 8:00a.m. and 5:00p.m. Central Time, Monday through Friday, at 1-800-805-7938 or (605)328-6807. After hours you may leave a message on the confidential voice mail of the Utilization Management Department and someone will return your call. You can also fax the Plan at (605) 328-6813.

Providers registered with an account through myHealthPlan are also able to submit information for prior authorization. The portal offers Providers a secure website to submit prior authorization requests via Express Requests. Just sign in to your account, hover on ‘Provider Resources’, click on ‘Express Requests’, click on ‘I need to obtain preauthorization/precertification’, enter the information in the named fields and click on ‘Submit’. A Utilization Management representative will respond to your request back to your myHealthPlan account.