The Preauth & Care Plan Tool is an online system to enter and review medical preauthorization requests for Select Health members. Using this tool is the fastest and best way to enter this type of request at Select Health.

Here are some of the tool's benefits for your clinic:

• Fewer overall required steps to preauthorization for your patients
• No more duplicative efforts and errors inherent in paper submissions
• Reduced response time, follow-up calls, and decision delays
• Auto-approval for some services
• No risk of member information being lost or sent to the wrong place
• Access to approval/denial letters

For Select Health Participating Providers

To use the Preauth & Care Plan Tool, you must first be granted access to the Select Health secure Provider Access Point, which protects member and provider information. This site requires a secure access login and enrollment in 2-step authentication.

Step 1: Get a Secure Access Login

To get a secure access login, you will need to submit BOTH:

1. The Login Application — The official request for access; list all new users on this form. Check the box for both Provider Benefit Tool and the Preauth & Care Plan Tool.
   (Note: Using Google Chrome is recommended; there may be some functional limitations if using Internet Explorer.)
2. The Information Technology Services Agreement (ITSA) — An agreement between your office and Select Health regarding access to the Select Health system. You need only complete and return pages 1 and 14 of the agreement.
   (Note: If you are adding a user to an existing account, you only need to submit the login application.)

Email all completed documentation to providerwebservices@selecthealth.org.

Step 2: Enroll in 2-Step Authentication

Select Health and Intermountain Health are committed to enhanced cybersecurity. Download our guide to help you quickly get set up with the necessary 2-step authentication.

-----------------------------------------

For Intermountain Health Providers

Select your state for instructions on signing up for Preauth & Care Plan Tool access.

• Utah
• Idaho
• Nevada
• Colorado

Intermountain Medical Group Staff 

Submit a request through AccessHUB by:

• Logging in using your master user ID and password.
• Clicking on Start an Access Request. Use the dropdown field to choose whether you are requesting access for yourself or are a manager requesting access for an employee.
• Typing “Preauth & Care Plan Tool” in the search box on the top right of the Applications page. Click the + sign to Add to Access Request.

NOTE: If you have not done so already, you will also need to request access to the Provider Benefit Tool for the Preauth & Care Plan Tool to work properly.

Affiliates

Using the Preauth & Care Plan Tool requires a secure login account.^*

For new accounts, complete and submit BOTH the:

• Information Technology Services Agreement (ITSA)
• Login Application

For a new user on an existing account, submit ONLY the Login Application.

Access to online preauthorization, claims, and eligibility information is available to participating providers only. Noncontracted providers can call Member services at 800-538-5038 for benefits, eligibility, and claims information.

In the Episode Details section, use the Request Priority field to select either “Standard” or “Expedited.” If you choose “Expedited,” please make sure to include clinical documentation that explains the medical necessity and urgency of the request along with a brief note, contact name, and direct phone number in the Notes field.

The preferred method is to use the Dashboard, where you can view your requests through widgets like:

• My Requests
• Requests by Type
• Decisions Made Today

Alternatively, you can search for a specific authorization by using the Search Request option. To do this, go to the Application Banner at the top of the screen or open the Menu, select “Search Request,” and enter any relevant criteria to filter your search.

From the Application Banner, click “Menu.” Select “New Request.” Enter the member’s Last Name, Date of Birth (DOB), and Subscriber ID, and then click “Search.”

A list of member plans, both active and inactive, will appear. Before selecting the member, be sure to verify their active coverage and choose the appropriate plan.

Once you’ve identified the correct member, click “Add Request” to proceed.

Click “Attach Providers.” Use any of the available search criteria (e.g., enter the provider’s last name in the Provider Last Name/Facility field) and click “Search.” Search results will show on the right side. Verify the Address and In Network fields to ensure accuracy.

If the same provider/facility is both Requesting and Servicing:

1. Select “Requesting and Servicing” in the “Provider Role” field.
2. Click the cog and choose “Single Attach.”

If there are separate Requesting and Servicing providers:

1. Search for the Requesting Provider.
2. Select “Requesting” in the Provider Role field.
3. Click the cog icon and choose “Multiple Attach.”
4. Search for the Facility.
5. Select “Servicing” in the Provider Role field.
6. Click the cog icon and choose “Multiple Attach.”
7. Click the green “Attach” button when finished.
8. If you need to add another Servicing provider, select “Additional Servicing” in the Provider Role field.

NOTE: Every request must include both a Requesting and a Servicing provider. For inpatient requests, a facility is required and may serve as both the Requesting and Servicing provider.

If you still don’t see your provider, please contact our Provider Web Services team at providerwebservices@selecthealth.org to make sure your account is correctly associated to the provider you’re searching for.

Yes. You can also search by NPIN/NPI. 

You can add multiple CPT codes in the Service Request section. Enter the first code in the Service Code field and complete any required fields. Click “Add.” The code will appear below. Enter the next code and click “Add” again.

IMPORTANT: Only enter one code at a time.

In the Code Type field, you can choose from:

• CDT
• CPT
• HCPC
• UM Service Group (used for services including Chiropractic, PT/OT/ST, Dental Anesthesia, SNV, Hospice, and PDN for commercial plans)

IMPORTANT: Include your direct contact information in this field to avoid review delays.

In case the reviewer has questions, you should provide your name, your direct phone number (with extension) and/or email address.

Put any additional information that you believe we need to know to make a determination (e.g., hardware details, assistant surgeon NPI#, etc.). Do not copy and paste clinical information in this field.  Clinical notes should be included as an attachment.

Yes. We need this information to review the request.

Clinical information can be combined into one attachment. Only one clinical attachment can be added before saving the request. Once the request has been submitted, additional clinical information can be attached by going to “My Requests” on the dashboard, clicking the cog, and selecting “Open.” Click “Add Document” and enter the document title. Click “Browse,” attach the clinical information, and click “Save.”

Please refer to the Code Lists for information on noncovered codes and codes that require preauthorization review. Please do not enter codes that do not require preauthorization. This can delay the processing of your request. If you still have questions, call Member Services at 800-538-5038.

Use the Optional Field link in the Service Request section to add units.

To reduce the time needed for preauthorization, we have identified several services for which requests can be automatically evaluated. For these specific services, the Preauth & Care Plan Tool compares the request to established criteria as follows:

• If criteria are 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

Read the Auto-Approvals PDF guide to learn which services are eligible and how to submit requests.