Why CareAffiliate

This preauthorization system is a great time-saver for your practice (some requests even qualify for auto-approval). As we transition from fax/email preauthorization requests to electronic requests only, switching to CareAffiliate now will help your practice prepare for the future.

With CareAffiliate, your practice benefits from:

• Fewer overall required steps to preauthorization for your patients
• No more duplicative efforts and potential errors when staff enter information from a paper form
• Reduced response time, follow-up calls, and decision delays due to missing information
• No risk of faxed member information being lost or sent to the wrong fax number
• Automatic review and preauthorization decisions for many procedures

Read the CareAffiliate Frequently Asked Questions.

Get Started with CareAffiliate!

Need access? Use of CareAffiliate requires access to the Select Health secure Provider Portal (login required). Find instructions on how to get access for:

• Participating Providers: Access the login application and Information Technology Services Agreement (ITSA). Learn more.
• Intermountain Providers/Caregivers
• Intermountain Nevada Providers/Caregivers

Check out CareAffiliate Training.

Learn more by downloading these online resources:

• Quick Reference Guide (how to enter your request)
• Request Type List (which request types align with the service you request)
• Authorization Status Guide (how to check the status of your requests)
• Instructions for Accessing Letters (how to view authorization letters online)
• Instructions for Viewing Provider/Facility Network Status (how to verify in-network locations)

CareAffiliate Auto-Review/Approval Process

To reduce the time needed for preauthorization, we have identified several services for which requests can be automatically evaluated (auto reviewed). For these specific services, CareAffiliate compares the request to established criteria as follows:

• If criteriaare met, the preauthorization will be automatically approved with no further review required.
• If criteria are not met, the preauthorization request is automatically sent to medical staff for review.

Preauthorization approved using this auto-review process will be examined to confirm that the clinical documentation submitted with request supports the authorized services.

Each clinic will be reviewed periodically, drawing from random samples of their authorizations. Clinics need to pass this review with a 90% accuracy rate. When providers don’t achieve a passing score, Select Health will:

• Provide personalized coaching on inconsistencies and recommendations to promote accurate documentation
• Conduct a follow-up review to ensure recommendations have been instituted
• Evaluate clinic eligibility for future auto-reviews only after three unsuccessful reviews