Independent Health Prior Authorization

Independent Health publishes service-specific prior authorization guidance. Start with the payer resource below, then confirm the member's plan and the requested service before care is scheduled or submitted.

At a glance

Independent Health uses prior authorization / preauthorization for selected services and drugs. The exact request path varies by product and delegated vendor: member preauthorization is described on the member site, pharmacy prior authorization for some drugs is handled through Prime Therapeutics via the secure provider portal, and self-funded services have a separate prior authorization request form. Official provider pages point providers to the secure provider portal and/or vendor workflows for the current requirements.
Rules differ by line of business and by delegated administrator/vendor.
Some prior authorization functions are delegated (for example, Prime Therapeutics for selected pharmacy authorizations).
The member-site preauthorization instructions are written for members, but they describe the timing expectation relevant to the operational process.
This research did not find a single consolidated provider prior authorization manual publicly accessible on the official site.

Where to verify prior authorization requirements

How to submit prior authorization requests

secure provider portal
member services phone request for member preauthorization
fax/mail form submission for some delegated/self-funded services
Submission resource 1
Submission resource 2
Submission resource 3

Information commonly required

service/requested drug
requesting provider information
servicing provider information
medical necessity support / clinical documentation
physician order and/or Certificate of Medical Necessity when applicable

Turnaround notes and caveats

Member preauthorization requests should be made 15 calendar days in advance of service or within 48 hours of the first business day following emergency services and/or admission.
The commercial/self-funded form states Independent Health must have the necessary information to process the request timely; no universal approval turnaround time was found in the sourced materials.
Rules differ by line of business and by delegated administrator/vendor.
Some prior authorization functions are delegated (for example, Prime Therapeutics for selected pharmacy authorizations).
The member-site preauthorization instructions are written for members, but they describe the timing expectation relevant to the operational process.
This research did not find a single consolidated provider prior authorization manual publicly accessible on the official site.

Provider resources

Provider Relations contact (official)
Provider Directory (official)
Transaction Assistant (official)
Provider portal entry points and tools (official)
Scope Provider Newsletter archive (official)

Sources

Fact	Value	Source	Confidence
Member preauthorization timing	Request should be made 15 calendar days in advance or within 48 hours after emergency services/admission.	Official	high
Prime Therapeutics delegated prior authorization	Providers can access the Prime Therapeutics prior authorization page via Independent Health’s secure Provider Portal.	Official	high
Self-funded prior authorization form	Use only if the member ID card says 'Independent Health Self-Funded Services'.	Official	high
Clinical documentation required	Attach physician order and/or Certificate of Medical Necessity plus supporting clinical documentation.	Official	high

Last reviewed: March 27, 2026

Sources used: 4 official