Magnolia Health Plan
Magnolia Health Plan > For Providers > Pre-Auth
Pre-Auth
Our convenient code look up tool will instantly let you know if you need a pre-authorization for a specific procedure, medication or revenue code.
If an authorization is required for the requested procedure, to submit an authorization Login here.
Out-of-network providers must submit a pre-authorization for all procedures. Join Our Network
Please note: Certain services may not be covered. Please refer to the state specific benefit coverage and limitations, including behavioral health and long term care services, age/diagnosis-specific authorization requirements, and self-referral services.
| Type of service | Authorization Required? |
|---|---|
| Services in an Federally Qualified Health Center, Department of Health, or Rural Health Clinic | NO |
| Family Planning services billed with a V25 through V25.9 diagnosis | NO |
| Emergency Room and Urgent Care Services | NO |
| Services by an anesthesiology provider (other than pain management and dental anesthesia) do not require pre-authorization | NO |
| Evaluation and management services rendered in the office by a plastic surgeon | NO |
| All elective services arranged by or provided by a non-participating provider | YES |
Disclaimer: Code validation is not a guarantee of payment.