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 

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
  • Industry standard for standard prior authorization reviews are typically around 15 days after medical records are received

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
  • 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)

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.

 

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