In order to maintain quality and medical management standards, the services provided to our members are continually evaluated.
Prior Authorization is the standard industry process of receiving approval for certain procedures and medical services within HMO and PPO plans. It is used to ensure that the medical community is providing accurate and necessary care.
Saint Mary’s Health Plans HMO Members
Your Primary Care Physician or Specialist obtains this on your behalf. We encourage you to call 800.863.7515 to confirm if Prior Authorization has been obtained, when required.
To view services that require Prior Authorization for your HealthFirst HMO plan (Northern NV member), click here.
To view services that require Prior Authorization for your HMO plan through HealthCare Partners (Southern NV member), click here.
Saint Mary’s Health Plans PPO Members
Ensuring that Prior Authorization has been acquired is the member’s responsibility. Your physician may obtain this on your behalf, but we encourage you to call 800.433.3077 to confirm if Prior Authorization has been obtained, when required.
To view services that require Prior Authorization for your Health Choice PPO plan, click here.
