Every insurer has different prior authorization rules, portals, and processes. Navigate the complexity with our payer-specific guides, or let Greenlight automate prior auth across all payers.
Automate Prior Auth for All PayersClick on any insurer below to see their prior authorization requirements, portal information, submission tips, and frequently asked questions.
UnitedHealthcare (UHC) is the largest commercial health insurer in the United States, covering over 50 million members. UHC prior authorization requir...
Anthem Blue Cross Blue Shield is one of the largest health insurance companies in the U.S., serving over 45 million members across 14 states. Anthem p...
Aetna, a CVS Health company, provides health insurance to over 34 million members. Aetna prior authorization requirements apply to advanced imaging, m...
Cigna Healthcare, now part of The Cigna Group, serves over 18 million members in the U.S. Cigna prior authorization requirements cover advanced imagin...
Humana is a leading health insurance company serving over 17 million members, with a particularly strong presence in Medicare Advantage. Humana prior ...
Blue Cross Blue Shield (BCBS) is a federation of 34 independent, locally operated companies that collectively provide health insurance to over 115 mil...
Medicare is the federal health insurance program covering over 65 million Americans aged 65 and older, as well as certain younger individuals with dis...
Medicaid is a joint federal and state program providing health coverage to over 90 million low-income Americans. Because each state administers its ow...
Prior authorization (also called prior auth, pre-authorization, or precertification) is the process of obtaining approval from a health insurance company before a medical service is provided. Each insurer maintains its own set of prior authorization requirements, clinical criteria, submission portals, and review processes.
For healthcare providers, this means navigating different portals, documentation requirements, and timelines for every payer. A procedure that needs prior auth from UnitedHealthcare may have completely different documentation requirements than the same procedure for an Anthem BCBS member. Some payers route imaging authorizations through third-party vendors like eviCore or AIM Specialty Health, adding another layer of complexity.
Greenlight Medical eliminates this complexity by automating prior authorization across all major payers. Our platform knows each insurer's specific requirements, portal submission processes, and clinical criteria, so your staff doesn't have to.
Look up prior authorization requirements for specific procedures and imaging studies by CPT code.
See how prior authorization impacts specific medical specialties including cardiology, orthopedics, oncology, and more.
Stay up to date with the latest prior authorization news, regulatory changes, and best practices.
Greenlight Medical automates prior authorization across UnitedHealthcare, Anthem, Aetna, Cigna, Humana, Medicare, Medicaid, and more. Let our platform handle the payer complexity.
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