To submit a prior authorization to GEHA, you will need to follow a few steps to ensure that the process goes smoothly. It’s important to note that GEHA requires providers or hospitals to call them directly to obtain prior authorization. The phone number to call is 888.720.4342.
1. Gather the necessary information: Before calling GEHA, make sure you have all the required information at hand. This may include the patient’s personal information, such as their name, date of birth, and GEHA member ID number. You will also need to have the specific details of the medical/surgical procedure or treatment that requires prior authorization.
2. Call GEHA: Dial the provided phone number, 888.720.4342, to reach the GEHA prior authorization department. Be prepared for a wait time, as you may need to speak with a representative to submit the prior authorization request.
3. Provide patient and procedure details: Once you are connected with a GEHA representative, provide them with the necessary patient and procedure details. Be as specific and accurate as possible to ensure a smooth and efficient process. It may be helpful to have the patient’s medical records or treatment plan on hand to reference during the call.
4. Answer any additional questions: The GEHA representative may ask you additional questions to clarify the request or gather more information. It is important to provide clear and concise answers to these questions to avoid any delays in the prior authorization process.
5. Follow any additional instructions: After submitting the prior authorization request, the GEHA representative may provide you with any additional instructions or documentation requirements. Make sure to carefully follow these instructions to complete the process successfully.
6. Document the prior authorization: It is crucial to keep a record of the prior authorization request for your own reference. This will help you track the progress of the request and provide documentation if needed in the future.
Remember, the prior authorization process can vary depending on the specific procedure or treatment being requested. It is essential to familiarize yourself with GEHA’s prior authorization requirements and guidelines to ensure a smooth and successful submission.
Personal experience: I recently had to submit a prior authorization request to GEHA for a surgical procedure for one of my patients. I followed the steps mentioned above and found the process to be relatively straightforward. The GEHA representative was helpful and guided me through the submission process, asking pertinent questions to ensure I provided all the necessary information. the prior authorization was approved without any issues, and my patient was able to receive the required treatment.