Peach State’s Utilization Management Department hours of operation are Monday through Friday (excluding holidays) from 8 a.m. to 5:30 p.m. Urgent Requests and Admission Notifications should call (800) 704-1483 and follow prompts.
- To notify the plan of inpatient hospital admissions and observations by the next business day of admission. A telephone authorization must be followed by a fax submission of clinical information by next business day.
- You may also call to request outpatient authorizations for urgent and time sensitive services when warranted by the patient’s condition. Please include CPT and ICD-9 codes and place of service codes with your authorization request.
For authorization requirements for the following services, please contact the vendors listed below.
- Hitech imaging such as: CT, MRI , PET and all other imaging services: National Imaging Association (NIA) - http://www.radmd.com
- Chemotherapy and Radiation Cancer treatments: eviti- eviti.com
For authorizations related to home health, home infusion, durable medical equipment and supplies, call Peach State Health Plan at: 1-800-704-1483.
- ED Hospital Claim Review Process
- Hospital to Hospital Back Transfer Policy (PDF)
- Notification of Newborn Delivery (PDF)
- Prior Authorization Hospital Letter (PDF)