Denver-Health-Medical-Plan Prior Authorization Lookup
- Denver-Health-Medical-Plan coverage criteria
- Denver-Health-Medical-Plan contact directory
- All Denver-Health-Medical-Plan policy updates
Latest Denver-Health-Medical-Plan prior authorization updates7
- Prior AuthClinical/Medical PolicyEff. 2026-01-01Prior Authorization Requirements — Specialty Pharmacy and Related SuppliesDefines prior authorization criteria (age, prescriber, coverage duration, prerequisites, and other requirements) for listed specialty pharmacy drugs and related injection supplies under Denver-Health-Medical-Plan Elevate Medicare products. Affects prescribers and pharmacists submitting PA requests for the named products.All Denver-Health-Medical-Plan updates
- Prior AuthClinical/Medical PolicyEff. 2025-12-01Prior authorization requirements for specialty drugsDefines prior authorization requirements, clinical prerequisites, prescriber restrictions, coverage durations, and other PA criteria for multiple specialty pharmacy products for Denver-Health-Medical-Plan Medicare products (Elevate Medicare Choice HMO D‑SNP and Elevate Medicare Select HMO). Affects providers requesting coverage for listed drugs.All Denver-Health-Medical-Plan updates
- Prior AuthClinical/Medical PolicyEff. 2025-12-01Step Therapy Requirements — Part 1 (select drugs; Step 2 prior-therapy rules)Defines step therapy (prior trial) requirements for specific drugs and formulations for Denver-Health-Medical-Plan Elevate Medicare Choice (HMO D-SNP) and Elevate Medicare Select (HMO). Affects providers submitting pharmacy claims or prior auth for listed products.All Denver-Health-Medical-Plan updates
- Prior AuthClinical/Medical PolicyEff. 2025-10-01Formulary and Prior Authorization Guidelines for Outpatient DrugsGoverns the Denver Health Medical Plan Elevate outpatient pharmacy formulary, including tier definitions, prior authorization, generic substitution, exclusions, and medication request processes for members and providers.All Denver-Health-Medical-Plan updates
- Prior AuthClinical/Medical PolicyEff. 2020-01-01UNIFORM PHARMACY PRIOR AUTHORIZATION REQUEST FORMA standardized form and instructions for submitting pharmacy prior authorization (PA) requests to Denver Health Medical Plan's Pharmacy Department, including patient, prescriber, drug, clinical justification, and delivery information. Contains guidance on opioid-dependence medications and statutory PA exceptions effective Jan 1, 2020.All Denver-Health-Medical-Plan updates
- Prior AuthClinical/Medical PolicyDHMP Commercial Formulary — Pharmacy Coverage CriteriaGovernance and use of the Denver Health Medical Plan (DHMP) Commercial Formulary for DHHA self-funded employee plans; explains selection, access, prior authorization (PAR) process, and coverage tiers for providers and members.All Denver-Health-Medical-Plan updates
- Prior AuthClinical/Medical PolicyElevate Medicaid Choice and Elevate CHP+ Formulary InformationPart 1 of the Elevate Medicaid Choice and Elevate CHP+ closed formulary describing formulary purpose, selection process, prior authorization/step-therapy/quantity-limit definitions, member/provider contact information, exclusions, supply/renewal rules, tier structure, and sample medication entries with levels and requirements.All Denver-Health-Medical-Plan updates
Tool Description
Search Denver-Health-Medical-Planprior authorization policies by drug name, procedure, or policy title. Results include any policy that mentions prior authorization requirements (drug coverage criteria, imaging guidelines, site-of-service rules) not just documents titled “prior authorization.” Every result links to a full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
Filter by payer, specialty, policy type, or effective year; or search directly for a drug (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee arthroplasty”), or a policy number.
Coverage spans 110+ payers. Jump straight to the busiest prior-auth publishers: UnitedHealthcare, Cigna, Aetna, Anthem, and Centene. You can also browse the full policy updates feed.
Pair a prior-auth search with the billing code lookup to confirm the CPT or J-code on the claim, the payer lookup for plan footprint, and payer profiles for contacts and coverage context.
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Prior auth requirements change all the time. Keep up with every payer policy update in the live policy feed, or browse payers with prior authorization policies.
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