Prior Authorization

Arkansas State and Public School Employees precertification (PDF) is done through American Health Holding (AHH). You may contact AHH at 501-682-6088 or 1-800-592-0358.

When To Seek Prior Approval

Some benefits provided by your Health Advantage health plan may require approval in advance of receiving medical services. Contact Customer Service if you have questions about prior authorization.

The following services always require prior authorization:

  • All out-of-network services
  • Health Advantage
  • Breast reductions (not related to cancer)
  • Health Advantage
  • Enteral formula
  • Health Advantage
  • IDET (Intradiscal Electrothermal Annuloplasty)
  • Health Advantage
  • Select injectable medications
  • Health Advantage
  • Swing bed care (prior approval by case management)
  • Health Advantage
  • Transplants (excluding kidney and cornea)

High-Tech Scanning Procedures

Arkansas Blue Cross has implemented a new prior approval program that requires physicians to obtain an authorization when ordering the following outpatient high-tech imaging procedures for their patients.

  • PET scans
  • CT scans
  • MRI/MRA
  • Nuclear cardiology

Physicians are not required to obtain an authorization when these services are performed in an emergency room, observation bed stay or for patients who are hospitalized.