Prior Authorizations
Effective July 1, 2024, providers are required to submit Commercial, PEIA, and Mountain Health Trust (WV Medicaid and CHIP) prior authorizations through The Health Plan (THP) provider portal. Fax and phone requests are not accepted.
Please review prior authorization requirements below and check plan benefits.
Prior Authorization Requirements
Medical and Behavioral Health
Current:
- Effective 4/15/25 - Medical and Behavioral Health Prior Auth Requirements
Upcoming:
- Effective 8/1/25 - Medical and Behavioral Health Prior Auth Requirements
Durable Medical Equipment (DME)
Current:
- Effective 7/1/25 - DME Prior Authorization Requirements
Upcoming:
Pharmacy
Medical Benefit, Medically Administered Drugs
Current:
- Effective 7/1/25 - Medical Pharmacy Prior Authorization Requirements
Upcoming:
Does your code require prior authorization?
Access THP's secure MyPlan Provider Portal to begin your request.
To view past prior authorization requirements, visit the provider portal - Authorizations.
Did you know? THP's provider communications notify you about upcoming prior authorization requirements.
Sign up for provider communications on the provider portal.