Imperial Insurance Company Prior Authorization

Imperial Insurance Company prior authorization rules are often service-specific rather than universal, so the safest workflow is to confirm the requirement in the payer's provider resources before scheduling or submitting care. The notes below summarize the most actionable provider-side guidance captured in the research set for this payer.

At a glance

• Prior authorization is required for services not listed on the Direct Referral Form, and inpatient services always require prior authorization. Nonparticipating providers must obtain prior authorization for all services. Requests can be submitted through the provider portal, fax, hard copy/written requests, or orally. The manuals state the UM team verifies eligibility, benefits, and required clinical information before review.
• Behavioral health requests are carved out to a behavioral health organization.
• Some requirements vary by plan/state and by in-network versus nonparticipating provider.
• The Texas marketplace PDF references the Imperial Provider Portal, but the exact portal URL was not visible in the captured text.

Where to verify prior authorization requirements

• Verification resource 1
• Verification resource 2

How to submit prior authorization requests

• provider portal

• fax

• hard copy / written request

• oral request

• Submission resource 1

• Submission resource 2

• Submission resource 3

Information commonly required

• member name
• member address
• member telephone number
• member ID number
• diagnosis codes (ICD-9/10)
• requested service codes (CPT)
• requested provider
• Primary Care Physician or Specialist name
• TIN
• telephone number
• fax number
• clinical support information
• current clinical information
• signed authorization form
• requesting provider name and NPI
• rendering provider name, NPI, and TIN
• service requested start and end dates
• quantity of service units requested
• physician signature

Turnaround notes and caveats

• The cited materials emphasize timely requests and date/time stamping, but do not provide a single universal turnaround time in the excerpts reviewed.
• The manuals state authorization decisions follow established timelines, but those timelines were not fully extracted from the accessible excerpts.
• Behavioral health requests are carved out to a behavioral health organization.
• Some requirements vary by plan/state and by in-network versus nonparticipating provider.
• The Texas marketplace PDF references the Imperial Provider Portal, but the exact portal URL was not visible in the captured text.

Provider resources

• Texas provider page (official)
• Texas provider directory (official)
• California provider page (official)
• Arizona provider page (official)
• Utah provider page (official)
• 2025 Medicare Provider Manual PDF (official)
• Texas preauthorization requirements PDF (official)
• Transparency in Coverage / claim submission page (official)

Sources