How to request prior authorization

Use the information below to submit prior authorization requests for medical, behavioral health, pharmacy, and medical benefit drug services that require review by Point32Health. You’ll find information on which services require prior authorization on our policy pages and our prior authorization grids.
PoliciesPrior Authorization Grids

For medical and behavioral health services that require prior authorization through Point32Health, please submit your request using one of the options below.

Submit electronically — preferred

For faster processing and administrative ease, we recommend submitting prior authorization requests through our HPHConnect or Tufts Health Plan secure portals. Information on registering for our secure portals is available on our electronic services webpage. You can also find step-by-step guidance for conducting portal transactions on our Training webpage.

Fax available

Please refer to this UM fax lines reference sheet for the appropriate fax numbers by product for medical and behavioral health services.

Tips to keep in mind:

Some services are managed by vendor partners and authorization must be requested directly through them. For details on vendor programs, refer to the vendor page of the provider website. 

If the utilization management team requires additional clinical information, you will receive instructions on how to submit the necessary documentation. A separate fax number may be provided specifically for this submission. You may also be able to upload clinical documentation via the portal; refer to the portal user guides for details.


Electronic submission


Electronic submission is encouraged for prior authorization requests for pharmacy and medical benefit drugs. We recommend utilizing PromptPA, our online tool, or electronic prior authorization (ePA) to submit your request. Fax and mail options are also available. For more information about how to request prior authorization for pharmacy and medical benefit drugs go to this page.