Claim Manager Authorizations

To find out what services must be authorized by the claims manager, check out our fee lookup tool.

Two ways to submit your request

  • Complete the attached preauthorization form
    • Completing this form creates a high priority work item for the claim manager and solicits needed information allowing the claim manager to act upon your request.  During testing this form has proven highly effective in expediting claim manager authorizations.
  • Call the claim manager
    • For urgent requests call your claim manager
    • Be sure to identify the procedure code(s), dates of service, diagnosis, prescribing provider and your contact information when requesting authorization.

Below are common services authorized by claims managers

  • Consultations, such as;
    • Psychiatric,
    • Pain Clinics.
  • Referrals to mental health specialists.
  • Chiropractic visits with physicians who use E/M office visit codes.
    • Office calls in excess of the first 20 visits or 60 days (whichever occurs first).
  • Most inpatient hospital admissions.
  • Outpatient surgeries/procedure:
    • All treatments require claim manager authorization.
  • Home nursing, attendant services or convalescent center care must be authorized per provisions outlined in WAC 296-20-091.
  • See L&I's Drug Policy page for more information .

Don't know who is the claims manager?

  • You can call the Interactive Voice Response Message System (800-831-5227) to obtain the name and phone number of the claim manager on a particular claim.
  • Call 360-902-6767 and your call will be forwarded to the appropriate claim manager.
  • Note: If you are the attending provider you can also check the Claim and Account Center, to see if treatment has been authorized on a claim.

 

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