How this process works:
Submitting a Preauthorization Request is a simple alternative to calling our office. Complete one of the forms (select the appropriate one depending on the requested service) and submit the completed form along with pertinent/requested clinical information to ICM for review. You may submit by uploading documents to our secure website (click to upload files), via fax to 503-654-8570, or by secure email to onlineprecert@innovativecare.com.
Please note that standard email is not secure and as such, confidential information should not be transmitted by standard email. Many organizations have access to secure email systems; if your organization doesn’t, please submit requests via the upload option or by fax.
Prior Auth for DME (Arizona Providers Only)
Prior Auth Request Form for Health Care Services (Arizona Providers Only)