- To begin the prior authorization process, please fill out a prior authorization form. The most up to date prior authorization forms to submit can be found in the Versant Health provider portal in the Dashboard under ‘Forms’.
- To ensure proper processing, the prior authorization form should be completely filled out, and checked for accuracy.
- To support prompt determinations, the clinical information required for our reviewers to make a determination can be found in our clinical policies. Clinical policies are located on the provider portal and on the Davis Vision and Superior Vision websites. The direct link to the clinical policies is https://versanthealth.com/policies/.
- Davis Vision: Clinical information that may be required in color can be emailed to [email protected].
- Superior Vision: Clinical information that may be required in color can be emailed to [email protected].
- It is important to remember that our policies are not the only policies utilized to review for medical necessity, medical policy quarterly updates can be located at https://prc.versanthealth.com/guides/.
- In addition, Versant Health must comply with state and federal regulatory criteria in a hierarchical system, if applicable. For example, Medicare or state specific Medicaid criteria are utilized for review, if available, before Versant Health clinical policies are applied to the review process.
- Policies are reviewed and updated annually to ensure the most appropriate evidence-based practices are reflected in our policies.
Helpful Links
- Versant Health Provider Resource Center
- Prior Authorization Submission Tips Video (Selecting the correct form): Videos – Provider Resource Center
- Quarterly Clinical Policy Updates: https://prc.versanthealth.com/guides/
- Clinical Policies: https://versanthealth.com/policies/
As always, if assistance is needed, please contact the Utilization Management Department.