Step 1:

Under Select the Requesting Provider, type all or part of the last name, first name and provider ID to find the provider requesting the authorization; then click Find Providers.

The matching providers are displayed in the bottom part of the screen.

Step 2:

Under Please Select a Provider, click the checkbox next to the correct provider and then click Next.

Step 3:

Under Select the Requesting Member, type all or part of the last name, first name and member ID to find the provider requesting the authorization; then click Find Members.

The matching providers are displayed in the bottom part of the screen.

Step 4:

Under Please Select a Member, click the checkbox next to the correct provider and then click Next.

Step 5:

Under Place of Service, select the appropriate place of service.

Step 6:

In the CPT 1 box, type the applicable CPT code. Repeat for CPT 2 and CPT 3, if necessary.

Click Next.

Step 7:

Review the information for the authorization. If all is correct, click Finish.

The authorization request is submitted. Print the screen for your records.