For providers: How can I get prior authorization for a medical drug?

Who is this for?

Michigan Health Insurance – Customer Service – How To

If you're a doctor prescribing a specialty drug that requires our approval, you can log in to Provider Secured Services and request authorization.

When a patient needs a specialty drug and we need to approve it first, you can ask for authorization online in Provider Secured Services. Look for the link to Medical Benefit-Medication Prior Authorization on the home page. Here's how to make sure you have access.

What you need to request medical drug authorization

First, the request must come from a medical doctor. The doctor can practice in an office or a facility.

Then, you'll need access to to Provider Secured Services. If your office or facility has never used Provider Secured Services: You'll need to sign up. This article has the instructions and forms.

Who can't access medical drug authorization

If you're one of these providers, you can't request authorization. The patient's doctor must do that.

  • DME
  • Billing and insurance services
  • Immunization pharmacies
  • Specialty pharmacies
  • Ambulatory infusion centers
  • Home infusion therapy

If you need an approval date or authorization number for the claim form, contact the doctor prescribing the drug.