Prior Authorization

Some services require Prior Authorization (PA) from Louisiana Healthcare Connections in order for reimbursement to be issued to the provider. To determine if a service requires PA, please use our Prior Authorization Prescreen Tool.

Standard PA requests should be submitted for medical necessity review at least seven (7) business days before the scheduled service delivery date or as soon as the need for service is determined. Failure to obtain authorization may result in an administrative claim denial.

As a reminder, Louisiana Healthcare Connections providers are contractually prohibited from holding any member financially liable for any service administratively denied by Louisiana Healthcare Connections for failure on behalf of the provider to obtain a timely authorization.

PA requests may be submitted by fax, by phone or by Secure Web Portal using our updated Prior Authorization Fax Forms (Inpatient Fax Form, Outpatient Fax Form). PA requests must include all necessary clinical information. Urgent PA requests should be submitted as soon as the need for the service is determined. Review PA Fax Form FAQs.

Certification of Ambulance Transportation must be submitted for all non-emergency ambulance transportation requests.

Fax the following PA requests to the corresponding fax number:

Form Fax Number           
Inpatient Fax Form/Admissions/Face Sheet 1-877-401-8175Image of Phone Reciever
Outpatient Fax Form/Medical Services/Home Health 1-877-401-8175Image of Phone Reciever
Concurrent Review–Clinical/Census 1-877-668-2080Image of Phone Reciever
Outpatient Therapy (Cenpatico/STRS) 1-855-254-1798Image of Phone Reciever
High Tech Imaging (NIA) 1-888-656-3602Image of Phone Reciever
Vision (Opticare) 1-252-451-2133Image of Phone Reciever
Certification of Ambulance Transportation
(If urgent, call 1-866-595-8133)


High Tech Imaging Services (CT, MRI) are authorized by National Imaging Associates at

For Mental Health Services outside of Bayou Health, please fax to
1-800-424-4399Image of Phone Reciever .

For more information, please refer to your Provider Manual.