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Prior Authorization (PA) / Notification requirements

Please select from the drop-down menu for services that require prior authorization or notification.

    • 72-hour Continuous Glucose Monitoring

    • Security Health Plan considers a 72-hour continuous glucose monitoring system (CGMS) a “stand-alone” system. A CGMS used with an insulin pump does not apply to this form.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Abdominoplasty

    • Abdominoplasty is a surgical procedure that tightens a lax abdominal wall and removes excess abdominal skin. It may be reconstructive or cosmetic.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Acute Rehabilitation Admission

    Security Health Plan requires pre-certification from naviHealth for this service.

    • Call: 1-855-512-7002
    • Fax: 1-855-847-7243

    Click here for more details.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Air Ambulance Transport

    Security Health Plan provides coverage for air/helicopter transportation in a critical emergency situation when ground ambulance is not medically safe or appropriate due to time constraints. Contact Security Health Plan at 1-800-991-8109 for questions regarding prior authorization for this service.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Amino Acid Formula

    • Oral amino acid-based infant formula (e.g., Neocate, Elecare, Nutramigen AA) requires prior authorization.

      Security Health Plan requires prior authorization for this service.  Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Antibiotic - Antiviral Intravenous Infusion

    • Security Health Plan has identified intravenous antibiotics and intravenous antifungals that have a high potential to be inappropriately or unnecessarily prescribed. The intent of this prior authorization is to reduce the development of drug-resistant bacteria, promote the use of cost-effective antimicrobial regimens, and reduce the use of parenteral therapies when oral regimens may be just as effective.

      Security Health Plan requires prior authorization for this drug. Please call 1-800-548-1224.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Autologous Cultured Chondrocytes

    • Autologous cultured chondrocytes, also known as Carticel, are a type of cartilage tissue graft. Indications for use are for the repair of cartilage defects of the knee, including meniscal knee injuries, chondromalacia, and other disorders of cartilage of the knee.

      Security Health Plan requires prior authorization for this drug. Please call 1-800-548-1224.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Breast Reduction Post Mastectomy

    • If this request is for the treatment of breast cancer, no prior authorization is required due to the Women’s Health and Cancer Rights Act of 1998, both reconstruction and implants are covered. This covers both affected and non-affected breast.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Carpal Tunnel Surgery

    • Carpal tunnel syndrome is a condition of the wrist that results in pain and numbness. It is caused by a pinched nerve in the wrist.

      Security Health Plan requires pre-certification and certain criteria must be met to receive approval for this service.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Carpal Tunnel - Median Neuropathy - Specialty Consult

    • Carpal tunnel syndrome is a condition of the wrist that results in pain and numbness. It is caused by a pinched nerve in the wrist.

      Security Health Plan requires prior authorization and Shared decision-making ONLY for State of Wisconsin Employee Trust Fund (ETF) members. Please complete the form on the right.

      Click here for more details.

    Product line(s):
    • State of Wisconsin Employee Trust Fund
    • Chronic Hip Pain - Osteoarthritis - Specialty Consult

    • Referral to an orthopedic surgeon is required for chronic hip pain.

      Security Health Plan requires prior authorization and Shared decision-making ONLY for State of Wisconsin Employee Trust Fund (ETF) members. Please complete the form on the right.

      Click here for more details.

    Product line(s):
    • State of Wisconsin Employee Trust Fund
    • Chronic Knee Pain - Osteoarthritis or Meniscal Degeneration - Specialty Consult

    • Referral to an orthopedic surgeon is required for chronic knee pain.

      Security Health Plan requires prior authorization and Shared decision-making ONLY for State of Wisconsin Employee Trust Fund (ETF) members. Please complete the form on the right.

      Click here for more details.

    Product line(s):
    • State of Wisconsin Employee Trust Fund
    • Clinical Trials

    A “clinical trial” is a type of research study that tests how well new medical treatments or other interventions work. Clinical trials are one of the final stages of a research process designed to test new methods of screening, and to find better ways to prevent, diagnose, or treat diseases.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Product line(s):
    • Commercial
    • Medicare Advantage
    • Cosmetic Reconstructive Surgery

    Cosmetic services are defined as services and procedures to improve the patient’s self-esteem, personal well-being, or to indirectly treat psychiatric or emotional problems or disorders, as well as procedures done solely to improve appearance. This would also include services and procedures provided in connection with or resulting from complications of cosmetic services or procedures.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Durable Medical Equipment - Prosthetic - Orthotic Suppliers

    A provider must submit the prior authorization for durable medical equipment (DME) to Northwoods. Durable medical equipment (DME) is equipment needed for medical reasons, which is sturdy enough to be used many times without wearing out. A person normally needs this kind of equipment only when ill or injured. It can be used in the home. Examples include wheelchairs, crutches, IV infusion pump, nebulizer, walker, hospital beds, or equipment that supplies a person with oxygen.

    Security Health Plan requires prior authorization for these services.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Elective Inpatient Admission

    Pre-certification is the process of reviewing an inpatient admission prior to the proposed admission date.  In general, affiliated hospitals or the admitting provider contacts Security Health Plan to pre-certify elective inpatient admissions/procedures.

    This prior authorization includes medical, surgical and behavioral health procedures.

    Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Electrical Stimulation and Electromagnetic Therapy - Service

    • Electrical stimulation: is the application of electrical current through electrodes placed directly on the skin in close proximity to the wound. Electromagnetic therapy: is a type of therapy involves the placement of electrodes or electromagnetic waves creating an electric current that passes  through the wound. It is thought that electrical current will speed wound healing.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Experimental or Investigational Services

    The use of any service including treatment, procedure, facility, equipment, drug, object, device, or supply that:

    • requires approval that has not been granted by the appropriate federal or other governmental agency at the time it is used,
    • is not yet recognized as acceptable medical practice to treat that illness or injury, or
    • is the subject of an ongoing clinical trial that meets the definition of a Phase I, II or III clinical trial set forth in FDA regulations, regardless of whether the trial itself is subject to FDA oversight.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Fecal Transplant

    Fecal microbiota transplant (FMT) is a procedure in which fecal matter, or stool, is collected from a tested donor, mixed with a saline or other solution, strained, and placed in a patient, by colonoscopy, endoscopy, sigmoidoscopy, or enema.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Product line(s):
    • Commercial
    • Genetic Testing

    • Effective January 1, 2017, genetic testing, used to detect mutations in genes associated with “familial medical conditions”, is performed to determine whether an individual has inherited a mutated version of the gene.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Family Health Center
    • High-end Imaging Services - CT Scan

    eviCore handles prior authorization of all high-end imaging services.  HEI include MRI, PET, CT and Nuclear Cardiac Services. 

    Security Health Plan requires prior authorization from eviCore for this service.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • High-end Imaging Services - CTA

    eviCore handles prior authorization of all high-end imaging services.  HEI include MRI, PET, CT and Nuclear Cardiac Services.

    Security Health Plan requires prior authorization from eviCore for this service.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • High-end Imaging Services - Low Dose CT for Lung Cancer Screening

    eviCore handles prior authorization of all high-end imaging services.  HEI include MRI, PET, CT and Nuclear Cardiac Services.

    Security Health Plan requires prior authorization from eviCore for this service.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • High-end Imaging Services - MRA

    eviCore handles prior authorization of all high-end imaging services.  HEI include MRI, PET, CT and Nuclear Cardiac Services.

    Security Health Plan requires prior authorization from eviCore for this service.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • High-end Imaging Services - MRI

    eviCore handles prior authorization of all high-end imaging services.  HEI include MRI, PET, CT and Nuclear Cardiac Services.

    Security Health Plan requires prior authorization from eviCore for this service.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • High-end Imaging Services - PET

    eviCore handles prior authorization of all high-end imaging services.  HEI include MRI, PET, CT and Nuclear Cardiac Services.

    Security Health Plan requires prior authorization from eviCore for this service.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Home Health

    • Home health includes healthcare services provided directly to a member in the member’s home. A written home care plan submitted by the member’s attending physician and approved by Security Health Plan is required. 

      This prior authorization includes skilled nursing, physical therapy, occupational therapy and speech therapy services.

      Security Health Plan requires prior authorization for this service.  Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Home Infusion - Chemotherapy

    • Chemotherapy is used for cancer therapy.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

      Click here for more details.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Hospice

    Hospice services can be provided either inpatient or at home. Hospice is specific care, such as pain management, provided to a member whose life expectancy, as certified by a physician, is six months or less.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.  To determine if this prior authorization applies to your patient, call 1-800-548-1224.

    Click here for more details.

    Product line(s):
    • Commercial
    • Hospital Admission - Pre-certification

    Pre-certification is the process of reviewing an inpatient admission prior to the proposed admission date.  In general, affiliated hospitals or the admitting provider contacts Security Health Plan to pre-certify elective inpatient admissions/procedures.

    Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Click here for more details.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Hospital Observation Admission

    Facility will send notification, along with clinical, within 24 hours of admission to observation status.

    Security Health Plan requires prior notification for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Hysterectomies for Diagnosis of Fibroids

    Prior authorization is required for both inpatient and outpatient procedures only for leiomyoma (fibroids).

    Security Health Plan requires prior authorization and Shared decision-making ONLY for State of Wisconsin Employee Trust Fund (ETF) members. Please complete the form on the right.

    Click here for more details.

    Product line(s):
    • State of Wisconsin Employee Trust Fund
    • Infuse Bone Graft

    • Patients with degenerative disc disease of the lumbar or cervical spine who have failed to respond to conservative therapy can be treated with a surgical procedure, referred to as spinal fusion or arthrodesis. Bone grafts are commonly used in this procedure to promote fusion of adjacent vertebrae.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Intrastromal Corneal Ring Segments

    • The device (INTACS) is indicated for the reduction or elimination of myopia and astigmatism in patients with keratoconus, who are no longer able to achieve adequate vision with their contact lenses or spectacles, so that their functional vision may be restored and the need for a corneal transplant procedure may potentially be deferred.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • Commercial
    • Medicare Advantage
    • Intravenous Immunoglobulins - Subcautaneous Immunoglobulin Infusion

    • Immune globulin is a sterile, purified preparation of human immunoglobulin derived from pooled human plasma from thousands of donors. Consisting primarily of immunoglobulin G, one of five classes of immunoglobulin (Ig), each batch of immune globulin provides immunomodulating peptides and antibodies against most exogenous antigens, many normal human proteins, and Fab, the antigen-binding region of autoantibodies. All currently available products contain high concentrations of IgG with subclass distribution corresponding to that of normal serum.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • IV Infusion Therapy Authorization Request

    This prior authorization includes TPN and hydration.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Knee Arthroscopy

    • Arthroscopy is a minimally invasive procedure that allows direct visualization of the interior of a joint. Knee arthroscopy allows orthopedic surgeons to assess, and in some cases treat, a range of conditions affecting the knee joint.

      Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Lipectomy

    • Lipectomy is the excision of fatty tissue.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Medicare Advantage
    • Low Back Pain - Orthopedic or Neurosurgery - Specialty Consult

    • Referral to an orthopedic surgeon, neurosurgeon for low back pain.

      Security Health Plan requires prior authorization and Shared decision-making ONLY for State of Wisconsin Employee Trust Fund (ETF) members. Please complete the form on the right.

      Click here for more details.

    Product line(s):
    • State of Wisconsin Employee Trust Fund
    • Long Term Acute Care Admission

    LTAC (Long-term acute care)  initial reviews are reviewed by naviHealth prior to admission to the facility.

    Security Health Plan requires pre-certification from naviHealth for this service.

    • Call: 855-512-7002
    • Fax: 855-847-7243

    Click here for more details.

    Product line(s):
    • Commercial
    • Medicare Advantage
    • Lung Volume Reduction Surgery

    • Lung volume reduction surgery (LVRS) is a general term encompassing a variety of surgical procedures that are offered to alleviate the symptoms of advanced chronic obstructive pulmonary disease (COPD).

      Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Medicare Advantage Coverage Inquiry

    • Per the Medicare ruling, members are allowed an organization determination for services that may not be covered by the plan. The organization determination is a request made by the provider via the ‘Medicare Advantage Coverage Determination Request’ form to the Health Plan to verify if a service would be covered or not.

      Security Health Plan requires prior authorization for this service.  Please complete the form on the right.

    Product line(s):
    • Medicare Advantage
    • Non-affiliated Providers Request

    • Security Health Plan requires prior authorization for services received by non-affiliated providers. Please complete the form on the right.

      Click here for more details.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Non-emergent Ambulance Transport

    Prior authorization is required for medical necessity of the non-urgent ambulance transport.

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Oral Appliance

    • An oral mandibular appliance is a device that is inserted into the mouth in order to modify the position of the mandible, tongue, and other structures in the upper airway for the purpose of relieving snoring or sleep apnea.

      Security Health Plan recommends prior authorization for this service for all plans. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Outpatient Therapy Treatment Concurrent

    • A request for concurrent therapy treatment is required for any additional services needed after the initial services have been approved.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

      Click here for more details on physical, speech and occupational therapy.

      Click here for more details on therapy guidelines.

    Product line(s):
    • Commercial
    • Medicare Advantage
    • Outpatient Therapy Treatment Initial

    • Once the initial evaluation is completed, an "Initial Therapy Request" form for outpatient physical therapy must be requested prior to receiving additional therapy services.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • Commercial
    • Medicare Advantage
    • Panniculectomy

    • Panniculectomy is a surgical procedure that removes excess skin, subcutaneous tissue, and adipose tissue from the abdomen. It is often performed after a patient has experienced childbirth or a large amount of weight loss resulting in redundant abdominal tissue.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Parenteral Nutrition Home Infusion

    • Total parenteral nutrition (TPN) peripheral parenteral nutrition (PPN) are a provision of daily nutrients and caloric requirements provided intravenously to a patient who is unable to receive nutritional intake via oral or tube feeding.

      Security Health Plan requires prior authorization for this service.  Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Port Wine Stain - Abnormal Vascular Lesion Treatment

    • Port-wine stain is a red to blue colored discoloration of the skin present at birth that mostly occurs on the face, but may also be present elsewhere. It generally does not enlarge out of proportion or resolve over time.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Radiation Oncology Services

    Radiation oncology requires prior authorziation. Contact eviCore at 1-888-665-8341.

    Security Health Plan requires prior authorization from eviCore for this service.

    Click here for more details.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Reduction Mammoplasty

    • Reduction mammoplasty or breast reduction surgery reduces the volume and weight of the  breasts by removing excess fat, glandular tissue, and skin. The goals of the surgery are to relieve symptoms caused by heavy breasts, to create a natural, balanced appearance with normal location of the nipple and areola, to maintain the capacity for lactation, and allow for future breast exams and mammograms with minimal scarring or decreased sensation.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Rhinoplasty

    • Rhinoplasty is surgical reshaping of the nose, generally for cosmetic reasons, unless there has been a recent traumatic injury to the nose that results in nasal airway obstruction.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Second Opinion

    Security Health Plan allows members to receive a second opinion from an in-network provider (without a referral) or an out-of-network provider (with an approved prior authorization).

    Security Health Plan requires prior authorization for this service. Please call 1-800-991-8109.

    Click here for more details.

    Product line(s):
    • BadgerCare
    • Commercial
    • Septoplasty

    • Septoplasty is the surgical repair of the nasal septum, which is the tissue, bone and cartilage that separates the nostrils, so that it is straight and centered. Septoplasty can improve nasal breathing and reduce nasal obstruction.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Site of Service Office and Outpatient Based Procedure

    Prior authorization is required for site of service for P2, P3 and R2 indicators.

    Prior notification and approval may be required by Security Health Plan for outpatient procedures (i.e. site of service care requests). Please call 1-800-991-8109.

    Product line(s):
    • Commercial
    • Site of Service Inpatient Based Procedure

    Prior authorization is required for inpatient procedures being requested to be performed in an ASC.

    Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Skilled Nursing Facility Admission

    Prior authorization must be obtained from naviHealth for admissions to and concurrent stays at a skilled nursing facility.  A skilled nursing facility (SNF) primarily furnishes skilled nursing and rehabilitation services performed by or provided under the supervision of licensed nursing personnel or professional therapists.

    Security Health Plan requires pre-certification from naviHealth for this service.

    • Call: 1-855-512-7002
    • Fax: 1-855-847-7243

    Click here for more details.

    Product line(s):
    • Commercial
    • Medicare Advantage
    • Spinal Cord Stimulator

    • Spinal cord stimulator (SCS) consists of a lead which delivers electrical stimulation to the spinal cord, an extension wire which conducts electrical stimulation from the power source to the lead, and a power source which generates the electrical stimulation.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Surgical Treatment for Obesity

    • Please contact Security Health Plan to determine if a member has coverage for surgical treatment for obesity.  If a member has coverage, prior authorization is required.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Swing Bed Admission

    All swing bed admissions must be prior authorized. A swing bed is a skilled nursing facility (SNF) type of care that is delivered in a hospital or critical access hospital (CAH) that has swing bed (SB) status.

    Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Product line(s):
    • Commercial
    • Medicare Advantage
    • Synagis

    • Synagis® (palivizumab), a monoclonal antibody, is used as a prophylaxis to reduce lower respiratory tract disease caused by respiratory syncytial virus (RSV) in high-risk children.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Total Hip Replacement

    • Total hip replacement arthroplasty is a surgical procedure that replaces a worn out or damaged hip with an artificial joint (prosthesis).

      Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Total Knee Replacement

    • Total knee arthroplasty is an operation in which a damaged knee joint is surgically replaced with an artificial joint (prosthesis).

      Security Health Plan requires pre-certification for this service. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Transgender Services

    • Effective January 1, 2017, prior authorization is required for members requesting gender reassignment services. Please contact Security Health Plan to verify benefits and coverage criteria requirements.

      Security Health Plan requires prior authorization for this service. Please complete the form on the right.

    Product line(s):
    • BadgerCare
    • Commercial
    • Family Health Center
    • Medicare Advantage
    • Transplants

    All services related to transplants require prior authorization.

    Security Health Plan requires prior authorization for this service and pre-certification for admission. Please call 1-800-991-8109.

    Product line(s):
    • BadgerCare
    • Commercial
    • Medicare Advantage
    • Wearable Hearing Aids

    • Security Health Plan requires prior authorization for this service for members over the age of 18.  Please complete the form on the right.

      To determine if prior authorization for this service applies to your patient, call 1-800-548-1224.

    Product line(s):
    • Commercial