Meridian covers most care without a referral or medical review. However, some care needs prior authorization (PA) such as neuropsychological testing. A provider will fill out a Prior Authorization Request Form and send it Meridian. The PA request must be approved before you can get the care. When a provider submits a PA form, Meridian's clinical staff reviews the request(s) and decides if:
• It is medically necessary, which means that the healthcare services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms meet accepted standards of medicine
• You can get the care from a provider in our network within any county in Michigan.
• Seeking services out of network may require PA. All out-of-state services require prior authorization
Click here to read Meridian's Member Handbook.
Please contact Meridian if you have any questions.
Click here to download and print a neuropsychological evaluation referral form for your referring physician to complete.