Thank you for being a participating provider with Meridian and its family of plans. As part of our ongoing work to improve the prior authorization (PA) process for providers and members, we’re communicating essential updates about PA requirements.
We’re aligning with broader industry efforts, driven by commitments to regulatory agencies and America’s Health Insurance Plans (AHIP), to modernize and streamline prior authorizations. Our goal is to reduce administrative burden, simplify submission and approval processes, and facilitate timely access to appropriate, high-quality care.
A full list of code changes for Meridian Medicaid Plan, YouthCare HealthChoice Illinois, Wellcare, and Ambetter Health are available via each plan’s PA look-up tool.
- Visit Meridan’s Prior Authorization Page
- Use the left navigation menu to navigate to each plan’s PA web page
Access the PA look-up tools via each plan’s home web page.
Changes may include
- Removing PA requirements based on criticality of review and clinical need
- A more uniform set of PA requirements. This may include adding and changing some PA requirements to reduce confusion for providers and support future efforts to expand real-time responses to requests
For questions about specific PA codes, or how these changes affect your practice, please reach out to your Provider Engagement representative or contact our provider services team:
- For Meridian Provider Services call 866-606-3700, Monday through Friday, from 8 a.m. to 5 p.m.
- For Wellcare Provider Services call 855-538-0454, Monday through Sunday, from 8 a.m. to 8 p.m.
- For YouthCare Provider Services call 844-289-2264, Monday through Friday, from 8 a.m. to 5:30 p.m.
- For Ambetter Provider Services call 855-745-5507, Monday through Friday from, 8 a.m. to 8 p.m.
