Authorizations: Prior Auth (Pre-Certification)

Providers now have two options to request prior authorization (pre-certification) for an upcoming procedure through Valenz, our Utilization Review Accreditation Commission (URAC) accredited partner for utilization management.

Request by Phone

  • Call Valenz at (877) 608-2200 
  • Requests are processed with 3-5 days

Request Online 

  • Visit the Valenz portal
  • Relation to Valenz: I am a provider 
  • Request type: Precertification Request 
  • Admission type: Inpatient or Outpatient 
  • Fill in all related fields, including subscriber, patient, and facility information
  • Attach clinical files
  • Requests are processed with 5-7 days but can be completed at your convenience without hold time or transfers.

To verify patient benefits, please call Sana at (833) 726-2123.

Outpatient care requiring prior authorization:

  • Arteriograms & Angiograms of other than the heart
  • Bone Scans
  • Cardiac Rehab
  • CT Scans
  • Dialysis
  • DME (Durable Medical Equipment)
  • Home Health Care
  • Infusion Therapy (excluding antibiotic infusion therapy)
  • Intensive Outpatient Substance Abuse
  • In-Vitro Fertilization
  • Mental Health Services performed at a Residential Treatment Facility, under Partial Hospitalization, or in an intensive outpatient setting.
  • MRA
  • MRI
  • Occupational Therapy
  • Outpatient Hospice
  • Outpatient Surgeries (Performed in a Hospital or Ambulatory Surgery Center)
  • Pain Management Epidural Steroid Injection
  • Pain Management Radiofrequency Ablation or Rhizotomy
  • Pain Management Trigger Point or Facet Injections
  • PET Scan
  • Radiation Therapy
  • Respiratory Rehab
  • Speech Therapy
  • Speciality Injectable Medications

Inpatient care requiring prior authorization:

  • Hospice
  • Long Term Acute Care
  • Maternity Longer than the Federal Mandate (48 Hour Vaginal, 96 Hours C-Section)
  • Maternity within Federal Mandate (Recommended notification only for monitoring status of the case.)
  • Med/Surgical/Peds
  • Mental Health/Substance Abuse
  • Skilled Nursing Facility (SNF)
  • Spinal Fusion: Sana members with plans starting on or after June 1, 2023, must use their Carrum Health benefit for Spinal Fusion coverage.

Have questions for Sana?
Connect with Provider Support directly through the chat icon on most Sana pages or call us at 
(833) 726-2123 Monday through Friday, 7 AM to 7 PM Central.