Medical Policies and Authorization Forms

Ohio State Health Plan Prior Authorization

For the most current medical, pharmacy and behavioral health policies, please call the OSU Health Plan Medical Management Department at (614) 292-4700 or (800) 678-6269 and press option 0.

Claims that are denied for lack of prior authorization may be reconsidered for payment, less a 20 percent penalty. This penalty will be applied to the physician and the facility. If the provider wants the claims reconsidered for payment with the 20 percent penalty, the Medical Management Department will need notes or the requested records from the provider. Providers with reconsideration requests should call the OSU Health Plan Medical Management Department (614) 292-4700 or (800) 678-6269 and press option 0.

For the list of procedures requiring prior authorization, view the "Services Requiring Medical Necessity Review List"

• Durable Medical Equipment Prior Authorization Form
• Elective Inpatient Admission Precertification Form
• Infertility Authorization Form
• NGS Claim Form
• Nutritional Services Authorization Form
• Weight Management Form