Prior authorization
We update prior authorization requirements regularly to align with program or code changes. Please refer to our prior authorization requirements before delivering planned services:
You can request prior authorization in multiple ways:
Through our self-service portal: Log in to Availity® Essentials to verify a member’s benefits, coverage and eligibility. After confirming, access the prior authorization portal through the HealthSpring Medicare Advantage payer space and submit all supporting documentation.
Or submit to us: Refer to our prior authorization forms. Complete the forms in their entirety and attach pertinent clinical information.
Mail to:
HealthSpring
Attn: Prior Authorization
500 Great Circle Road
Nashville, TN 37228
Call or fax:
| Contact | Phone | Fax |
|---|---|---|
| Behavioral health | | 1-866-949-4846 |
| Drugs or biologics Part B | | 1-877-730-3858 |
| CareAllies | | 1-866-233-6235 |
| Clinical operations | | 1-866-287-5834 |
View Home Health Care Authorization Bundles.
Refer to our provider manual for more information.
Prior authorization statistical data
We compile statistical information associated with all prior authorization requests received in the previous year.
These reports include:
- How many authorizations were approved or denied
- Authorization review turnaround times, including average and middle wait times
- Review of urgent requests
- Details on approvals or deadline extensions
Review our 2025 prior authorization report.