Pre-Authorizations

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Coventry Health Care values the quality care that health care providers give our members. To support that effort, Coventry has multiple options for obtaining the information you need to maximize every patient visit, including our exclusive, free website, directprovider.com

The prior-authorization process is now quick and easy with our secure online service, directprovider.com.  Providers can submit, look-up, or edit authorizations online, at their convenience.  And, with our exclusive Adjustment Reconsideration function, providers have the opportunity to request a review/reconsideration of an authorization and submit the documentation online in support of that request.

Coventry prides itself on the EDI tools it has available for its providers and, with directprovider.com, Coventry can boast one of the most multi-functional payer websites available to its providers in the healthcare industry.  For more information on directprovider.com, please visit the ‘Secure Provider Portal’ section of this website.

Prior Authorization

National Imaging Associates
PDF
Beginning April 1, 2015 National Imaging Associates, Inc. (NIA) will manage our new imaging program.  Very prior authorizations before scheduling a procedure at RadMD.com
Outpatient Cardiac Catheterizations
PDF
Effective July 1, 2015 the Cardiac Catherization Clinical Guidelines for Coventry Health Care of Iowa can be found at RadMD.com
Prior Authorization Quick Guide 2015
PDF
Precertification Medical Injectable List
PDF


Prior Authorization Forms

NuFactor (Gammaplex) OP Referral Form
PDF | 111 KB

Real-time Authorization Submission Inquiries

View information concerning other Coventry real-time authorizations solutions.

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