Prior Authorizations

Your Questions Answered

Community First Health Plans requires that certain services be authorized prior to being rendered.

Are You A Community First Member?

Learn more about referrals to specialists and prior authorization requests to help make the right choice for your family. 

The following documents are a detailed description of the different authorization processes and request forms required for Community First Health Plans:

Request Forms

See the full list of Prior Authorizations required for medical procedures/services by contracted and non-contracted providers below:

For a full list of Prior Authorizations compliant with Senate Bill 1742, please see the Prior Authorizations Compliant with SB1742 list.

2022 Prior Authorization Statistics

2021 Prior Authorizations Statistics

2020 Prior Authorization Statistics

2019 Prior Authorization Statistics

Member Assistance

If you are a Member and have questions about prior authorization, please call Member Services at 1-800-434-2347, Monday through Friday, 8 a.m. to 5 p.m. We are happy to help.

PROVIDER ASSISTANCE

If you are a Provider and have questions about prior authorization, please refer to our Provider Quick Reference Guide which includes helpful prior authorization phone and fax numbers.

⚠❗ Attention Community First Members! The COVID-19 Public Health Emergency has ended. All Medicaid and CHIP Members must renew their coverage to keep receiving benefits.

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