Prior Authorizations

Required Information for Prior Authorization
When requesting prior authorization the following information must be provided:

• Member name, ID number, and date of birth
  
• Name of facility where member will receive service
  
• Name of provider performing the service or procedure
  
• Expected date of service
  
• Service or procedure requested, including CPT/HCPCS code
  
• Clinical information related to service or procedure requested, i.e. what treatment has been tried and failed.

Providing complete information allows for timely processing by the Prior Authorization Department.

Global Obstetrical Care
Physicians performing obstetrical care must notify Missouri Care by completing and faxing the Pregnancy Risk Screening and Notification Form within two (2) business days of the initial visit of Missouri Care members for authorization of global obstetrical care. Missouri Care will then issue an authorization number required for reimbursement.