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MDwise Home|MDwise|For Providers|Prior Authorization

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Prior Authorization

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Prior Authorization

MDwise Medicaid Prior Authorization Process

For pharmacy prior authorization forms, please visit our pharmacy forms.

Resources

  • Portal Instructions - New!
  • Prior Authorization Reference Guide for Hoosier Healthwise and Healthy Indiana Plan
  • Prior Authorization Appeal Request Form
  • Universal Prior Authorization Form

Prior Authorization Lists

  • The Medical Prior Authorization and Exclusion Lists for Hoosier Healthwise and HIP effective 1/1/23
  • The Medical Prior Authorization and Exclusion Lists for Hoosier Healthwise and HIP effective 4/1/22
  • 2023 Searchable Behavioral Health Services that Require Prior Authorization for Hoosier Healthwise and HIP effective 1/1/2023
  • 2021 Searchable Behavioral Health Services that Require Prior Authorization for Hoosier Healthwise and HIP

For pharmacy prior authorization forms, please visit our pharmacy forms.

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    MDwise
    2955 N. Meridian St.
    Indianapolis, IN 46208
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  • Page Updated: 2/7/2023 9:40:31 AM

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